Thyroidectomy
Thyroidectomy is an operation in which one or both lobes of the thyroid gland are removed. The most common indications for thyroidectomy include a large mass in the thyroid gland, difficulties with breathing related to a thyroid mass, difficulties with swallowing, suspected or proven cancer of the thyroid gland and hyperthyroidism (overproduction of the thyroid hormone). The most common tests to determine whether a thyroidectomy is necessary include a fine needle aspiration biopsy, thyroid scan, ultrasound, x-rays and/or CT scan, and assessment of thyroid hormone levels.
The procedure is usually done under general anesthesia. The extent of surgery (removal of one or both lobes) may sometimes be determined in the course of surgery after microscopic examination of tissue removed during the surgery.
After surgery it is very common to have difficulties and/or pain with swallowing. This pain is usually resolves within 24 to 72 hours. Bleeding or infection are also possible short term complications. Although rare in thyroid surgery,some patients may develop a thick scar or keloid.
Two complications specific to thyroid surgery are hypocalcemia and vocal cord weakness or paralysis. Hypocalcemia, or low blood levels of calcium, may occur after complete removal of both thyroid lobes. This condition is caused by injury to four tiny glands called parathyroid glands, which are located within or very close to the thyroid gland. Hypocalcemia is usually temporary, but sometimes may require calcium supplements if sufficiently pronounced. Permanent hypocalcemia is fortunately rare. Vocal cord weakness or paralysis may be caused by swelling, stretching, or injury to the recurrent laryngeal nerve which passes very close to the thyroid gland. Temporary hoarseness may result. Again, this is an uncommon, ususally temporary complication. Permanent vocal cord paralysis is rare.
Depending on the final histologic (microscopic examination) diagnosis of the gland removed, continuous follow-up by your endocrinologist and/or surgeon may be indicated.
After Surgery
Patients are admitted to the hospital following surgery to ensure safe post-operative management. Once you are able to swallow liquids by mouth and can manage the wound drain, you may be discharged to home. Most patients are discharged within 24 hours of surgery.
Post-operative Instruction
1. Wound care: Empty the drain bulb twice each day and record the output. Once the sutures are out, you may wash the wound with soap and water and gently dry the area. Your ear and cheek will be numb for several months after surgery.
2. Diet: gradually advance to regular diet as tolerated.
3. You must stay away from NSAIDS, Aspirin, Motrin, or Advil for 5 days.
4. Follow up schedule: Pathology results are usually available 3-5 working days after surgery and you will be asked to follow up in 2-3 days for drain removal and then in 1 week for results of biopsy. Long-term follow-up is determined by the pathology.
