Thyroidectomy is the surgical removal of the thyroid glands. Learn what to expect and how to best recover after this surgical procedure.
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In this article:
- What Is a Thyroidectomy?
- When Is Thyroidectomy Necessary?
- What Happens During a Thyroidectomy?
- Where Is the Thyroidectomy Incision Made?
- How Do I Prepare for Thyroidectomy?
- What Are the Risks of Thyroidectomy?
- How Do I Take Care of Myself After Thyroidectomy?
- Why Is It Important to Rest for Thyroidectomy Recovery?
What to Expect Before, During, and After a Thyroidectomy
What Is a Thyroidectomy?
Also known as thyroid surgery, a thyroidectomy is the surgical removal of all or part of the thyroid gland. This procedure is usually given to patients who suffer from thyroid disorders.
There a number of types of thyroid surgeries, depending on the reason.
- Lobectomy or hemithyroidectomy. The doctor removes only part one of the two lobes of your thyroid gland and leaves the other part to perform its original function.
- Subtotal thyroidectomy. This procedure removes most of the thyroid gland but leaves a small portion of tissue to retain thyroid function.
- Total thyroidectomy. This type of surgery involves the removal of your whole thyroid, leaving no tissue behind.
- Isthmusectomy. This is the removal of the bridge of the thyroid tissues between the two lobes.
When Is Thyroidectomy Necessary?
The most common reason for a thyroidectomy is the presence of nodules or malignant tumors on the thyroid gland.
A thyroidectomy may also be used to remove inflamed or enlarged parts of the thyroid, especially if they are obstructing breathing or swallowing. Examples of such cases are:
- Goiter, or the abnormal enlargement of the thyroid gland
- Hyperthyroidism, or the excess production of thyroid hormones
- Hypothyroidism, or the insufficient production of thyroid hormones
- Thyroid cancer
What Happens During a Thyroidectomy?
The thyroidectomy procedure begins with a small incision. After the incision, the flaps around it are, elevated carefully to expose the thyroid gland.
Once the thyroid gland is identified, the surgeon identifies the lobe that needs to be dissected. The surgeon then identifies the parathyroid gland and carefully dissects it.
The surgeon proceeds to identify and stimulate the recurrent laryngeal nerve. Afterward, the thyroid gland is removed.
Parathyroid Gland Definition: Four tiny glands located next to the thyroid. They are in charge of controlling your body’s calcium levels.
Recurrent Laryngeal Nerve Definition: Responsible for the operation of the larynx and provides the majority of movement of the vocal cords.
Once the bleeding stops after removal, the surgeon proceeds to cleanly close the incision in a layered fashion.
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Where Is the Thyroidectomy Incision Made?
The thyroidectomy procedure is usually minimally invasive and only requires a small horizontal incision in the midline of the neck.
The incision is only 1 to 2 inches in length. To minimize scarring and visibility, the surgeon places it within a normal skin crease.
How Do I Prepare for Thyroidectomy?
Before the surgery, the patient undergoes blood tests to determine if a bleeding disorder is present. The use of blood thinning medications like ibuprofen or aspirin must be disclosed as this could affect the procedure and recovery.
The preoperative check may include imaging of the neck via CT scan or thyroid ultrasound.
To ensure that the recurrent laryngeal nerves are functioning properly, patients’ vocal cord function is evaluated and documented. This includes noting down a history of surgery on the organs inside and around the neck.
Unless instructed by the physician, diet or medication intake doesn’t change before the operation.
For patients over 45 years of age or who suffer from symptoms of heart disease, the doctors recommend an electrocardiogram and/or chest x-ray prior to the surgery.
What Are the Risks of Thyroidectomy?
Thyroid surgery is generally safe. The risk of serious complications is less than 2%.
Though complications are uncommon, below are possible thyroidectomy side effects or risks:
- Bleeding. There is a chance of bleeding during the hours right after the procedure. Patients should stay overnight in the hospital after the surgery.
- Recurrent laryngeal nerve injury. Injury to this nerve can cause temporary (up to 6 months) or permanent hoarseness. But the chances of this injury occurring is low.
- Low blood calcium levels. If your parathyroid glands are injured or removed during the operation, your blood calcium levels can drop. If so, ask your consulting physician for calcium and vitamin D supplements.
These complications rarely happen. They are commonly found in patients who suffer from:
- large goiters that go below the collarbone into the top of the chest
- invasive tumors or extensive lymph node involvement
How Do I Take Care of Myself After Thyroidectomy?
- The physician may ask patients to take the drug levothyroxine, an oral synthetic thyroid hormone post-op, depending on the extent of the operation. Because the body can no longer produce hormones of its own, self-administered thyroid hormones perform the function of the removed thyroid gland.
- A soft diet and increased fluid intake are recommended post-thyroidectomy.
- The incision must be cared for to prevent infection and opening. Make sure to cover it with a sterile dressing.
- See your surgeon two to four weeks after your surgery for a post-operative appointment. The surgeon will discuss pathology results if the thyroid surgery was done to rule out cancer and decide if further treatment is needed.
Why Is It Important to Rest for Thyroidectomy Recovery?
The thyroid gland is a vascular organ, which means it has a lot of nerve supply. And, these types of organs tend to need longer recovery periods than those with less connecting nerves.
Here are other things to remember:
- Thyroidectomy recovery takes about one to two weeks. You can return to work once you feel ready.
- Make sure to perform only light activities like walking post-thyroidectomy.
- When exercising, make sure not to lift anything heavy.
- And, it’s best to start driving if you are no longer taking pain medication.
Know what to expect when you are having thyroidectomy in this video from Clancy ENT:
A thyroidectomy is just one of the many options to treat a thyroid disorder. It is usually, like other surgical procedures, the last resort.
A diet plan or prescribed medications are still highly suggested to manage the condition. This is because these options preserve the normal functioning of the endocrine system without an invasive surgery.
What questions do you have about thyroidectomy? Let’s discuss them in the comments below.
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