Thyroidectomy refers to the surgical removal of all or part of your thyroid gland. The thyroid gland –a butterfly-shaped gland located in the front of the neck- produces hormones that control every aspect of your metabolism, from your heart rate to how quickly you burn calories. This surgery is performed to treat thyroid disorders, such as cancer, a noncancerous enlargement of the thyroid (goiter), and an overactive thyroid (hyperthyroidism). Depending on the reason for surgery, some or all of your thyroid gland may be removed. If only part of your thyroid is removed (partial thyroidectomy), your thyroid may work normally after surgery. But if the entire thyroid is removed (total thyroidectomy), you’ll need daily treatment with thyroid hormone to replace your thyroid's natural function.
Why would I need a Thyroidectomy?
A thyroidectomy is right for those with thyroid tumors, thyroid nodules, or hyperthyroidism, which occurs when the thyroid gland produces too much thyroid hormone. Hyperthyroidism may be the result of an autoimmune problem, too much iodine in the diet, a benign tumor in the pituitary gland, too much thyroid medication, and a swelling (goiter) in the thyroid gland, or an inflammatory process.
Why is thyroidectomy done?
Your doctor may recommend a thyroidectomy if you have conditions such as:
Thyroid cancer
Cancer is the most common reason for thyroidectomy. If you have thyroid cancer, removing most, if not all, of your thyroid will likely be a treatment option.
Non-cancerous enlargement of the thyroid (goiter)
Removing all or part of your thyroid gland is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing or, in some cases, if the goiter is causing hyperthyroidism.
Overactive thyroid (hyperthyroidism)
Hyperthyroidism is a condition in which your thyroid gland produces too much of the hormone thyroxine. If you have problems with anti-thyroid drugs and don't want radioactive iodine therapy, thyroidectomy may be an option.
Indeterminate or suspicious thyroid nodules
Some thyroid nodules can't be identified as cancerous or noncancerous after testing a sample from a needle biopsy. Doctors may recommend that people with these nodules have thyroidectomy if the nodules have an increased risk of being cancerous.
What are the risks of thyroidectomy?
Voice changes, such as hoarseness
Sore throat
Bleeding and blood clots
Adhesions or scar tissue that require another surgery
Injury to the esophagus or trachea (windpipe)
Hypoparathyroidism (too little parathyroid hormone, which can result in abnormally low blood calcium levels)
What happens during a thyroidectomy?
Before the procedure
The doctor will order imaging and laboratory tests, including:
Thyroid imaging with ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI)
Blood test(s) for thyroid hormone levels and other factors
Examination of the vocal cords using an instrument called a laryngoscope
For people with hyperthyroidism, the doctor will administer medications to keep thyroid hormones in balance during and after surgery.
Types of thyroidectomy
Traditional Thyroidectomy: Most thyroidectomies are performed under general anesthesia, meaning you are asleep and pain-free during the procedure. Your surgeon will make a small incision in the skin of the neck, then parts a thin layer of muscle to gain access to the thyroid gland, and then remove one or both lobes of the thyroid gland. Then the muscles of the front of the neck will be put back together and secured in place. You'll get sutures to close the skin.
Scarless (Transoral) Thyroidectomy: A newer technique involves accessing the thyroid gland through the mouth. This surgery leaves no visible scar since there is no incision on the outside of the neck.
How is the recovery process from thyroidectomy?
Depending on your condition, you may be sent home the same day or kept in the hospital overnight. They can observe you and monitor calcium levels in your blood. When the thyroid gland is surgically removed, the body still requires thyroid hormone to keep vital functions in balance. Thyroid hormone replacement therapy involves taking synthetic or naturally derived thyroid hormones in pill form.
Conclusion
In conclusion, a thyroidectomy is a surgical procedure that involves the partial or complete removal of the thyroid gland. This procedure is typically performed to treat conditions such as thyroid cancer, goiter, or hyperthyroidism. Despite being a major surgery, advancements in surgical techniques have made thyroidectomy a relatively safe procedure with a low rate of complications. However, it’s not without potential risks, including damage to the parathyroid glands and recurrent laryngeal nerves, which can lead to complications such as hypocalcemia and voice changes. Therefore, patients should be thoroughly informed about the procedure, its potential benefits, and risks. Post-operative care, including hormone replacement therapy for those who have had their entire thyroid removed, is crucial for recovery and maintaining a good quality of life.