The thyroid is a gland situated in the neck region, below Adam's apple and is made up of two lobes.
It produces hormones that are vital for different kinds of body functions such as growth, temperature regulation, and other metabolic activities.
At times, this hormone may be abnormally produced or there may be a growth seen associated with the gland that becomes problematic and requires the gland to be removed partially or completely.
This surgical procedure wherein the thyroid gland is removed, is called thyroidectomy.
The thyroid gland is removed in the following cases:
Any abnormal growth (cancerous tumor or benign nodular growth) that involves the thyroid gland.
Hyperthyroidism- if the thyroid secretes excessive hormones, and medications alone cannot manage the condition.
Goitre - enlarged thyroid gland that obstructs breathing.
An autoimmune disease called Grave's disease.
This procedure can be performed in one of the following ways according to the pathology that is seen in the gland:
It is a type of thyroid surgery in which the surgeon removes only one of the lobes of the gland that is involved with the abnormal tissue growth and the remaining part left behind, assumes the function of the gland.
In this procedure, the majority of the thyroid gland is removed and only a small portion of it is preserved so that it can secrete the necessary hormones.
However, it may not produce hormones up to normal levels and to compensate for this, the patient might have to take thyroid hormone supplements to restore balance.
The entire thyroid gland is removed in this surgery. It is done when the cancer is too advanced or if the abnormal growth involves the entire gland.
The doctor will conduct a complete health evaluation of the patient through clinical examination, necessary blood, and imaging tests.
Before the procedure, the safety of anesthesia will be tested in the patient. In cases of hyperthyroidism, the doctor may prescribe certain medicines to balance the levels of the hormone to lessen the complications during surgery.
The patient will have to fast the night before the surgery.
It is conducted under general anesthesia. Depending on the pathology of the disease, lobectomy /subtotal or total thyroidectomy may be performed by a suitable surgeon.
There are 3 types of approaches to the thyroid gland in thyroidectomy procedure:
The conventional thyroidectomy-The incision is made in the center of the neck
Transoral thyroidectomy-incision is made inside the mouth.
Endoscopic thyroidectomy-in this operation small incisions are made in the neck through which an instrument called the endoscope is inserted. It has a light source and camera fitted that helps the surgeon monitor the procedure and remove the gland.
Sometimes the pathology of the gland may have spread to the lymph nodes and the doctor may advise removing them as well. This will be discussed before the surgery with the patient.
Usually, 1-2-nights of observation depending on the health status of the patient is advised after surgery to monitor the success of the treatment and the surgical site. The patient can be discharged in 2 to 3 days post-surgery.
The patient may experience hoarseness in the voice and will be asked to avoid all heavy exercises and activities that may strain the neck region, strictly for a period of 2 weeks.
Pain and tenderness in the area operated and decreased levels of thyroid hormones experienced by the patient after the gland is removed can be managed by medications.
Medicines such as pain killers and synthetic derivatives of the thyroid hormone (in hypothyroidism seen after total thyroid gland removal) are prescribed by the doctor.
The patient may also be given calcium supplements sometimes. Regular follow-ups as advised by the doctor are necessary to clean and bandage the wound.
Complications due to the use of general anesthesia (airway obstruction, allergic reactions, etc).
Surgical complications like an injury to the nearby structures may cause bleeding.
Infection at the site of the wound can cause fever.
Temporary or permanent hoarseness in voice may occur due to injury to the recurrent laryngeal nerve(s) that supply the vocal cords.
Low calcium levels experienced as cramping, numbness, or tingling /pin and needle sensations-due to damage to parathyroid glands that are present near the thyroid gland.
On noticing any of the above-mentioned symptoms and signs, one must seek immediate medical care from a surgeon or doctor.
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