The Thyroid Gland: The thyroid gland is shaped like a bow tie; i.e. a larger lobe on each side of your windpipe (trachea) joined by a narrower isthmus. The thyroid gland commonly develops nodules. Most of the nodules are benign. Many of these benign nodules can be identified by outpatient studies such as fine needle biopsies. However, some of the nodules may be suspicious for cancer; and consequently need to be removed. Some nodules become so enlarged that they put pressure on the windpipe and cause the sensation of fullness in the lower neck. These large nodules are may be removed also. The thyroid gland secretes thyroid hormone that is essential for the body. Many patients will need to take a thyroid hormone supplement after surgery. Your primary care doctor or Endocrinologist usually monitors thyroid hormone levels annually.
The Parathyroid Glands: Most people have 4 parathyroid glands that rest adjacent to the thyroid gland or in the gland itself. These are the size of a pea. Parathyroid glands help maintain a normal level of calcium in your body. One or more the parathyroid glands may be removed during the surgery. Some patients may need to take a synthetic Vitamin D and calcium supplement. Your primary care doctor usually monitors your calcium levels after surgery.
The Recurrent Laryngeal Nerve: The nerve that controls much of the voice-box (larynx) runs adjacent to the thyroid gland. This nerve may not work well after surgery. This will lead to a hoarse, breathy voice and sometimes trouble swallowing. Most mild hoarseness, after surgery is due to temporary swelling of the vocal cords from the breathing tube (endotracheal tube) placed by the anesthesiologist during the procedure. If both lobes are removed, both the left and right recurrent laryngeal nerves may not work, and the patient may have trouble breathing. This may require placing a breathing tube to through or below the voice-box (TRACHETOMY).
Thyroidectomy: The removal of the thyroid gland starts with a skin incision in the lower neck, above the patient’s breastbone. The gland is carefully separated from the recurrent laryngeal nerve. The gland is also separated from any parathyroid glands that are seen. One or both of the lobes of the thyroid are removed. A small drain tube is placed to exit the skin near the incision. The incision is sewn closed. The patient is then monitored for bleeding.
The final pathology report may not be available until one week after surgery.
IF ONLY ONE LOBE OF THE THYROID WAS REMOVED AND THE PATHOLOGY SHOWS A MALIGNANCY, THEN ONE MAY NEED TO HAVE ANOTHER OPERATION TO REMOVE THE RESIDUAL THYROID.