The surgical removal of all or a portion of your thyroid gland is known as a thyroidectomy. The butterfly-shaped thyroid gland is situated at the front of your neck. It produces hormones that regulate every aspect of your metabolism, including how quickly calories are burned and your heart rate. 

To address thyroid problems, medical professionals undertake thyroidectomies. These include cancer, goiter, a hyperactive thyroid, and an enlarged, non-cancerous thyroid (hyperthyroidism). 

The cause for your thyroidectomy will determine how much of your thyroid gland is removed. After surgery, your thyroid may function normally if only a portion of your thyroid has to be removed (partial thyroidectomy). If you require a complete thyroidectomy, thyroid hormone must be taken regularly to restore the natural functions of your thyroid.

Why is it done? 

If you suffer from ailments like these, your doctor could advise thyroid surgery: 

Malignancy: The most frequent cause of thyroid removal is cancer. If you have thyroid cancer, one of your treatment options may be to have most or all of your thyroid removed. 

Goiter, a non-cancerous growth of the thyroid gland: If your goiter is significant, you may be able to have all or part of your thyroid gland removed. A big goiter may cause discomfort or make it difficult to swallow or breathe. If a goiter is making your thyroid hyperactive, it may also need to be removed.

Hyperthyroidism: Hyperthyroidism is a condition in which your thyroid gland generates an excessive amount of the hormone thyroxine. If you have side effects from anti-thyroid medications or don't want radioactive iodine therapy, thyroidectomy may be a possibility for you. These are two other popular hyperthyroidism therapies. 

Suspicious thyroid nodules: In certain cases, a needle biopsy sample cannot be used to determine whether a thyroid nodule is malignant or not. You could be a candidate for a thyroidectomy if your nodules have a higher likelihood of being malignant.

Risks 

In general, thyroidectomies are risk-free operations. Thyroidectomy does, however, include the risk of problems that come with any operation. 

Complications that might arise include: 

• Bleeding: Your airway may occasionally get blocked by blood, making breathing difficult. 
• Infection 
• Low levels of the hormone parathyroid (hypoparathyroidism): The parathyroid glands, which are found behind your thyroid, can sometimes become damaged during surgery. The parathyroid glands control the blood's calcium levels. You can feel tingling, cramping, or numbness if your blood calcium levels are too low. 
• Voice that is permanently hoarse or weak owing to vocal cord nerve injury. 

How you get ready ?

Pharmaceuticals and food 

Your doctor may advise taking medicine like iodine and potassium solution if you have hyperthyroidism. Your thyroid function can be controlled with medication, which also lessens your chance of bleeding following surgery. 

You might need to refrain from eating and drinking for a period of time prior to surgery in order to prevent anesthesia-related issues. You'll get detailed instructions from your healthcare practitioner. 

Other safety measures 

Ask a friend or family member to drive you home following the procedure the day before your operation. Jewelry and other valuables should be left at home.

What to anticipate ?

Prior to the process 

You won't be conscious throughout the thyroidectomy since general anesthetic is frequently used by surgeons. Your anesthesiologist or anesthetist will either inject a liquid anesthetic into a vein or administer an anesthetic as a gas for you to breathe via a mask. A breathing tube will be inserted into your trachea after you are asleep to help with breathing throughout the surgery. 

Your body will be fitted with many monitors by the surgical team so they can continuously check your heart rate, blood pressure, and blood oxygen level. These monitors consist of a blood pressure cuff on your arm and chest-mounted cardiac monitor wires.

Throughout the process 

The surgeon makes an incision low in the middle of your neck once you are asleep. It can frequently be positioned in a skin fold where it won't be visible until the incision has healed. The thyroid gland is subsequently removed whole or partially, depending on the surgical goal. 

The surgeon may inspect and remove the lymph nodes surrounding your thyroid if you are having a thyroidectomy because you have thyroid cancer. In order to avoid long-term harm in some patients, the surgeon employs specialized technology to monitor vocal cord irritation during the treatment. An average thyroidectomy lasts one to two hours. Depending on the complexity of the operation, it could take longer or less time.

Thyroidectomy can be done in a variety of ways, including: 

Traditional thyroidectomy: This procedure entails creating a cut in the middle of your neck to gain access to your thyroid gland. Most patients will probably be eligible for this surgery. 

Transoral thyroidectomy: With this procedure, the thyroid is accessed through a mouth incision. 

Endoscopic thyroidectomy: This method requires fewer neck incisions. Through the incisions, medical supplies and a tiny video camera are introduced. Throughout the surgery, your surgeon is guided via the camera.

After the process 

After surgery, you are sent to a recovery area where medical professionals keep an eye on your physical and mental recovery after the operation and anesthesia. 

A drain may need to be inserted under the neck incision in certain patients. Typically, this drain is taken out the day following surgery. 

Some people may suffer hoarse or weak voices after a thyroidectomy, along with neck discomfort. These symptoms normally disappear quickly. They might result from nerve irritation brought on by the surgery or from irritation from the breathing tube placed in the windpipe. In some instances, vocal cord damage that is permanent results in hoarseness or weakness.

After surgery, you'll be able to eat and drink normally. You could be able to leave the hospital the day of your procedure or spend the night there, depending on the type of surgery you underwent. 

Usually, you may resume your usual activities when you get home. Before engaging in any strenuous activity, such as heavy lifting or high-impact sports, wait at least  2 weeks. 

The surgical scar can take up to a year to fade. Sunscreen may be advised by your doctor in order to hide the scar.

Results 

The extent of the thyroidectomy will determine its long-term implications. 

Partial Thyroidectomy 

The remaining thyroid tissue usually assumes the role of the full thyroid gland if only a section of your thyroid is removed. Therefore, thyroid hormone treatment may not be necessary.

Total Thyroidectomy 

Your body can no longer produce thyroid hormone if your complete thyroid is removed. You'll experience symptoms of an underactive thyroid without treatment (hypothyroidism). These signs might manifest as dry skin, exhaustion, and weight gain. Every day, you must take a tablet containing the synthetic thyroid hormone levothyroxine (Synthroid, Unithroid, others). 

This hormone replacement serves all the same purposes as the hormone that your thyroid gland naturally produces. To determine how much thyroid hormone replacement you require, your healthcare provider will perform a blood test.

By RECMED MEDICAL - THYROIDECTOMY SURGEONS AND THYROID SPECIALISTS