Thyroidectomy, or surgical removal of the thyroid, is a common surgical solution for several diseases of the thyroid gland. The most common diseases that require a thyroidectomy include thyroid cancer, thyroid nodules, hormone-producing thyroid nodules, Graves disease and thyroid goiter. Any tests should be completed prior to consideration of thyroid surgery. Common tests given, include clinical exams, laboratory tests and imaging studies. Thyroid surgery can include removal of a portion of the thyroid gland (typically half of the gland), the majority of the gland or all of the gland, depending on the disease that is being treated.
After the patient visits his or her Endocrine and Neuroendocrine Tumor Program thyroid surgeon, an operative date will be scheduled. A patient with hyperthyroidism may receive medication prior to the procedure to help control any symptoms and minimize the risk of complications related to hyperthyroidism.
The patient will receive instructions on how to prepare for surgery, including any restrictions prior to surgery, and prior to the procedure, the anesthesiologist and surgeon will discuss anesthesia.
Thyroid surgery is performed in the operating room under anesthesia. An incision is made along the front of the neck within a skin crease to help hide the scar, which heals very well over time. The scar should be undetectable within a year.
Some surgeons may use a special type of breathing tube to monitor the function of vocal cord nerves during the operation. Any type of thyroid operation involves risk of injury or damage to these nerves, which can cause temporary or permanent hoarseness of the voice. Most experienced thyroid surgeons have a 1 percent or lower incidence of nerve injury; the patient should discuss this with the surgeon prior to surgery.
The parathyroid glands are four small glands located near the thyroid gland that function to control the calcium level in the blood. During thyroidectomy these glands are carefully preserved as the thyroid gland is removed. Occasionally, a parathyroid will lose its very delicate blood supply during surgery and need to be reimplanted into a nearby muscle, where it will begin to function normally a few weeks after surgery.
Following completion of the operation where general anesthesia was used, the breathing tube is removed and the patient is returned to the recovery room to continue waking up from anesthesia. Depending on the extent of a patient's surgery, he or she will be either discharged after a short stay in the recovery room or admitted to the hospital overnight.
The patient's voice may be somewhat weak or hoarse immediately following the procedure due to the proximity of the surgery to the voice box and from irritation related to the breathing tube. This will typically resolve during the first 24 hours.
Our physicians do not restrict the patient's diet following thyroid surgery, and the patient's ability to swallow will typically return to normal shortly after surgery. Relatively mild pain may follow surgery and can be controlled with acetaminophen, such as Tylenol, nonsteroidal anti-inflammatory drugs (NSAIDS), such as, ibuprofen or naproxen or narcotic pain pills. A patient who has undergone total thyroidectomy will need to replace the thyroid hormone in the form of a pill.
Any additional treatment is determined by testing the removed thyroid gland and lymph nodes. A final report is usually available several days following thyroid surgery, and our surgeons will discuss the results of the tests and the next treatment steps with the patient.
For a more extensive explanation of what to expect following thyroid surgery, see the Montefiore Thyroid and Parathyroid Patient Discharge Instructions.