The thyroid gland is a core part of the endocrine system that helps regulate the body’s metabolism. Built quite simply and shaped like a butterfly, the gland has two lobes connected via the thyroid isthmus and is found at the front of the lower neck. When disease affects the thyroid, its activity is often affected, causing imbalances in hormone secretion. Some diseases can also raise the need for a thyroidectomy – a surgical procedure to remove all or a section of the thyroid gland.
Why is thyroidectomy surgery done?
A thyroidectomy can be recommended for any of these conditions:
Cancer: The most common reason for thyroidectomy is to remove cancerous thyroid tumors. For those diagnosed with thyroid cancer, the treatment plan often involves removing part or all of the thyroid gland. A thyroidectomy can also be necessary if a biopsy on a thyroid nodule indicates inconclusive readings.
Goiter: It is a condition that causes enlargement of the thyroid gland. A thyroidectomy to remove all or part of the gland could be part of the treatment.
Hyperthyroidism: It is a condition where an overactive thyroid gland produces the hormone thyroxine in excess. If other treatment plans for hyperthyroidism like anti-thyroid drugs and radioactive iodine therapy are not an option for you, thyroidectomy may be necessary.
Types of thyroidectomy
Total thyroidectomy — The procedure entails removal of the entire thyroid gland.
Thyroid lobectomy — In this procedure, an entire thyroid lobe is removed.
Partial thyroid lobectomy — A rare procedure where only a part of one thyroid lobe is removed.
Thyroid lobectomy with isthmusectomy — An entire thyroid lobe is removed along with the isthmus between the two lobes.
Subtotal thyroidectomy — A small part of a thyroid lobe is left to preserve thyroid function. An entire lobe, the isthmus and a part of the other lobe are removed.
Complications of thyroidectomy
Although thyroidectomy surgery is usually a safe procedure, it could still give rise to a few minor or major complications such as:
Hemorrhage: Patients may develop a hemorrhage under the neck wound. The wound may bulge, making the neck swell and cause difficulty in breathing.
Injury to the RLN (recurrent laryngeal nerve) — This injury can lead to vocal cord paralysis. It can leave you with a husky voice, either for a short time or for the rest of your life. Similarly, an injury in the the superior laryngeal nerve can affect your ability to hit high notes, and your voice projection can be compromised.
Thyroid storm — This is a rare scenario since medicines are administered before the surgery to prevent the complication. But in cases where a thyroidectomy is done to treat hyperthyroidism, it could result in inducing a surge of thyroid hormones into the blood.
Hypoparathyroidism — If the parathyroid glands are affected during surgery, the body may not be able to produce sufficient parathyroid hormone. Low production of parathyroid hormone causes low blood calcium levels.
As in the case of most surgeries, most people will have a sore throat due to the breathing tube used for anesthesia. Pain at the point of incision will be minimal and patients are generally given mild pain medication. As the wound heals around the incision, you may experience itching for a few weeks. The incision may leave a scar depending on the procedure undertaken, but the scars usually heal well.
While walking and other regular activities can be resumed within a day the surgery, strenuous activity and heavy lifting are not recommended for 2 weeks. Depending on your work and lifestyle, you may need to take 1-2 weeks off work after a thyroidectomy. It may be more comfortable to eat soft foods for a few days.
Patients may also experience mild discomfort while swallowing or notice subtle changes in the voice, both of which will take a few days to settle. Variations in the voice can even take a few months to settle. The patients’ blood calcium levels will be tracked in the hospital and even after discharge to ascertain the functioning of the parathyroid glands.