ProvidersJohn R. Blumer, MD F. Brian Gibson, MD, FACS Robert E. Harley, MD S. Brett Heavner, MD Christopher T. Jones, MD, FACS Donald B. Kamerer, Jr, MD Timothy J. Kelly, MD, FACS Chad S. Kessler, MD Darrell A. Klotz, MD, FACS F.P. Johns Langford, MD, FACS Hugh M. Lovejoy, Jr, MD Michael S. Mallonee, MD Sajeev K. Puri, MD Todd R. Reulbach, MD Michael W. Sicard, MD Nicholas G. Stowell, MD Ross A. Udoff, MD Douglas B. Villaret, MD Mark T. Weigel, MD
WHAT IS THE THYROID?
Your thyroid gland is one of the endocrine glands that makes hormones to regulate physiological functions in your body, like metabolism. Other endocrine glands are the pancreas, the pituitary, the adrenal glands, and the parathyroid glands. The thyroid gland is located in the middle of the lower neck, below the larynx, and wraps around the front half of the trachea.
WHAT IS A THYROID DISORDER?
Thyroid diseases are very common, affecting millions of Americans. The most common thyroid problems are:
- Hyperthyroidism (an overactive thyroid gland)
- Hypothyroidism (an underactive thyroid gland)
- Thyroid enlargement
- Thyroid malignancy, caused by radiation therapy or family history
Thyroid problems can be treated with hormone replacement pills, medication, radioactive iodine, or surgery.
WHAT IS THYROID SURGERY?
Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital, and general anesthesia is usually required. Typically, the operation removes the lobe of the thyroid gland containing the lump and possibly the isthmus. A frozen section (immediate microscopic reading) may be used to determine if the rest of the thyroid gland should be removed during the same surgery.
Sometimes, based on the result of the frozen section, the surgeon may decide not to remove any additional thyroid tissue, or proceed to remove the entire thyroid gland, and/or other tissue in the neck. This decision is usually made in the operating room by the surgeon, based on findings at the time of surgery. Your surgeon will discuss these options with you before surgery.
As an alternative, your surgeon may choose to remove only one lobe and await the final pathology report before deciding if the remaining lobe needs to be removed. There also may be times when the definite microscopic answer cannot be determined until several days after surgery. If a malignancy is identified in this way, your surgeon may recommend that the remaining lobe of the thyroid be removed at a second procedure. If you have specific questions about thyroid surgery, ask your otolaryngologist to answer them in detail.
WHAT HAPPENS AFTER THYROID SURGERY?
During the first 24 hours:
After surgery, you may have a drain (tiny piece of plastic tubing), which prevents fluid and blood from building up in the wound. This is removed after the fluid accumulation has stabilized, usually within 24 hours after surgery. Most patients are discharged later the same day or the next day. Complications are rare but may include:
- Bleeding under the skin that rarely can cause shortness of breath requiring immediate medical evaluation
- A hoarse voice
- Difficulty swallowing
- Numbness of the skin on the neck
- Vocal cord paralysis
- Low blood calcium
Following the procedure, if it is determined that you need to take any medication, your surgeon will discuss this with you prior to your discharge. Medications may include:
- Thyroid hormone replacement
- Calcium and/or vitamin D replacement
Some symptoms may not become evident for two or three days after surgery. If you experience any of the following, call your surgeon or seek medical attention:
- Numbness and tingling around the lips and hands
- Increasing pain
- Wound discharge
- Shortness of breath
If a malignancy is identified, thyroid replacement medication may be withheld for several weeks. This allows a radioactive scan to better detect any remaining microscopic thyroid tissue, or spread of malignant cells to lymph nodes or other sites in the body.
Thanks to the American Academy of Otolaryngology - Head and Neck Surgery for this information.