The number of patients suffering from thyroid cancer or some other condition of the thyroid gland such as hyperthyroidism or goiter continues to rise each year. Primarily, steroids and other anti-inflammatory drugs, such as NSAIDs, are used to reduce inflammation of inflamed thyroid glands, but in severe cases where a patient finds difficulty in breathing or swallowing surgery may be the only solution.
Thyroidectomy, popularly known as thyroid surgery, is a surgical removal of part or all of the thyroid gland. This butterfly-shaped gland is located in the lower front portion of the neck, and just below your larynx (voice box).
The gland is formed by two cone-like lobes or wings (lobus dexter (right lobe) and lobus sinister (left lobe), and attached by a middle part (isthmus).
The surgery may be recommended for a variety of conditions including:
An overactive thyroid gland that produces extremely high levels of thyroid hormones, a growth (nodule or cyst) associated with the thyroid gland, cancer of the thyroid, a small thyroid growth, malignant (cancerous) thyroid tumours, benign (noncancerous) tumours of the thyroid that are causing symptoms, an enlarged thyroid gland (nontoxic goitre) that makes it hard for you to breathe or swallow.
Types of Thyroidectomy
- Total thyroidectomy- This is the most commonly used surgery which involves removing of entire gland. This surgery is often used for thyroid cancer, specifically the aggressive cancers such as follicular carcinoma of thyroid and medullary or anaplastic thyroid cancer.
- Hemithyroidectomy- In this type of surgery entire isthmus is removed along with 1 lobe of the thyroid gland containing the lump.
- Subtotal thyroidectomy- The surgery involves removal of the isthmus, one thyroid lobe, and part of the second lobe.
- Partial thyroidectomy- It involves removal of part of one thyroid lobe.
- Near total thyroidectomy- This surgery is done to remove both lobes leaving a small amount of thyroid tissue adjacent to the entry point of the recurrent laryngeal nerve into the larynx.
- Hartley Dunhill operation-This kind of thyroid surgery involves removing of one entire lateral lobe with isthmus and partial removal of opposite lateral lobe.
If partially removed, your thyroid may be able to function normally following the surgery, but if the whole gland has been removed you will need daily treatment with thyroid hormone to restore your thyroid's natural function.
The ultra modern technology and new methods of treatment have made thyroidectomy extremely safe, with decreased risks and improved results. The new minimally invasive video-assisted thyroidectomy requires smaller incisions (less than 2 inches long) in the neck, allowing patients to heal faster and return to their regular activities sooner as well.
Risks and complications associated with thyroidectomy
Although thyroidectomy may seem very appealing to you, it does carries a risk of complications.
The potential complications associated with thyroidectomy include wound infection pain, swelling, neck stiffness, sore throat
, bleeding beneath the neck, wound can interfere with breathing, anaesthetic complications
, surgical scar, airway obstruction can occur due to bilateral vocal cord paralysis
, weak voice due to nerve damage, either short-term or long-term temporary or permanent change in voice, temporary low levels of calcium in blood
and bones, the entire removal of gland needs for lifelong thyroid hormone replacement.
When to seek post-surgery medical attention?
Once you return home from the hospital, call your surgeon immediately if you develop symptoms like fever, numbness around your mouth and hands, tingling in the extremities, spasms in your feet, hands or you feel wound discharge and shortness of breath
As well, if your incision becomes red, tender or swollen, or your voice seems to be husky or weak, call your surgeon or seek medical attention
Also, symptoms of ongoing lethargy, fatigue and chronic tiredness should be reported to the physician.