Open Surgery

Training and involvement since 1987

Thyroid surgery


fig 1: Thyroid

Thyroid surgery
Thyroid surgery procedure, also known as thyroidectomy is performed whenever the thyroid gland is afflicted with some medical condition. Read this article to know about thyroid surgery instructions.
Thyroid gland, more often known as thyroid, is an important and also one of the largest endocrine glands, which is located in the neck, right below the thyroid cartilage. It secretes hormones triiodothyronine and thyroxine, which play a major role in regulating the metabolism rate of the body. These hormones are synthesized by tyrosine and iodine content in the food ingested. Besides the calcium levels in the body are regulated by calcitonin hormone that is secreted by thyroid. The pituitary gland and the hypothalamus control the functioning of thyroid.

However, if the secreting ability of this gland is affected (more or less than the regular secretion), it indicates that the gland is either hyperactive (hyperthyroidism) or underactive (hypothyroidism). Such alterations in hormone secretion by thyroid has many reasons to occur. In that case, a thyroid surgery procedure may be recommended depending on which part of the gland has become non functional. The surgery aims at removing a part or half or whole of the gland depending on the gravity of the medical condition. Now, keep reading to know about the surgery instructions.

Thyroid Surgery Instructions
Before understanding the instructions of thyroid surgery procedure, let’s see what are the reasons that cause thyroid problems.

  • Thyroid cancer
  • Enlarger thyroid gland
  • Multiple nodules in thyroid cartilage
  • Hyperthyroidism (in pregnant women), left uncontrolled by antithyroid drugs and radioactive iodine

Once the cause is diagnosed, your doctor will advise you on whether or not to go for thyroid removal surgery, depending on the seriousness of the medical condition. Now, let’s understand what instructions are dictated in thyroid surgery.

  • A few days before surgery, your doctor may prescribe iodine and potassium medications to regulate the thyroid function. You may also be required to refrain from eating certain foods to avoid any complications that may rise later due to anesthesia.
  • Before the surgery, the patient is sedated with general anesthesia. A 3 – 4 inch long incision is made above the joining place of collarbone and breastbone. Extreme care is taken in doing this, to prevent any neck muscles from getting cut.
  • Now the muscles are stretched wide to check which portion of thyroid needs to be removed. (This procedure is also known as thyroid lobectomy)
  • Once the defective section of the gland is removed, it is sent to the pathology lab for further investigation, to check for signs of cancerous development.
  • The parathyroid glands (the four glands next to the thyroid that produce parathormone to regulate calcium levels) are however kept intact.
  • In case the test result for cancerous development is positive, the entire gland is removed. Also some lymph nodes are removed, which may have been affected by cancer. But this depends on the type of thyroid cancer diagnosed during surgery.
  • Then the incision is closed by fixing the sutures. The thyroid surgery procedure is complete now.

Thyroid Surgery Recovery
Post thyroid surgery procedure, the patient is kept in the PACU (Post Anesthesia Care Unit). Once the patient regains consciousness, he might experience a sore throat and pain when swallowing. Because of removal of thyroid gland, the parathyroid glands are numbed for a while, which do not secrete enough parathormones to regulate calcium levels in blood. Hence the patient might also experience numbed lips, facial twitching and muscle cramps. Also, there is a small (less than ¼ inch) tube exiting from the neck which is used for draining out any fluids that may have got accumulated in the affected area. This condition persists for about a week and oral thyroid medications containing calcium supplements are provided to the patient.

Thyroid surgery recovery also depends on the care taken by the patient once he is discharged. After coming home, the patient can take a shower and wipe the operated area dry. For the first week post surgery, the patient is given warm and liquid foods as a mild sore throat is still felt. For 5 days antibiotics and pain relieving medications (like Tylenol) are prescribed. Aspirin, Advil, Motrin, Ibuprofen or NSAIDS are NOT to be taken until the stitches are removed. Driving is prohibited for at least a week post surgery. Then the follow up visits are scheduled for stitch removal. In the visit, the pathology reports are examined and the results are explained thoroughly to the patient. Approximately after a month, another visit is scheduled to check the healing process of the wound. Some medications that are taken post thyroid surgery procedure also includes artificial thyroid hormone pills by mouth, but it is not recommended until and unless prescribed by the doctor.

Thyroid Surgery Complications
Every surgery carries with it, its set of risks and complications. Some of the potential thyroid surgery complications (although the occurrence is rare) include:

  • Damage to surrounding nerves
  • Risk of bleeding and infection
  • Scarring
  • Change in voice (hoarseness)
  • Drop in calcium level in the blood
  • Airway obstruction
  • Stiffness in neck
  • Muscle cramps

So, this was all about thyroid surgery procedure. Nowadays, endoscopic thyroidectomy is also performed in which a camera is inserted through the incision and carbon dioxide is pumped into the infected area, to get a clearer view of the gland cross section. However, this surgery needs a lot of expertise and a person, who is to undergo thyroidectomy must get it done only by an experienced surgeon.