Thyroid & Parathyroid Surgery
Thyroid
The thyroid gland is a butterfly shaped organ that wraps around the trachea (windpipe). It lies just below the thyroid cartilage (Adam's apple). The gland produces thyroid hormone that has a role in regulating the body's metabolism. In many cases the symptoms of too much or too little thyroid hormone do not point specifically to a thyroid disorder. Symptoms can include changes in heart rate, feeling excessively hot or cold or changes in body weight. Blood tests can accurately determine thyroid function.
Common reasons for considering Thyroid Surgery
Goitre Goitre refers to the enlargement of the thyroid gland and is one of the most common reasons for thyroid surgery. The enlargement is most commonly due to multiple nodules within the thyroid (multinodular goitre). A large thyroid gland can apply pressure to surrounding organs, particularly the trachea or oesophagus, leading to difficulty with breathing or swallowing. An enlarged thyroid may also be easily visible and can be removed for cosmetic reasons.
Thyroid Nodules Nodules or lumps in the thyroid are very common and increase with age. Approximately 50% of the population aged over 50 years will have at least one thyroid nodule. They may be found by feeling the neck or during imaging scans. Most thyroid nodules are small and don't require further investigation. Where further tests are suggested, a needle biopsy is usually performed with ultrasound guidance. Surgery may be recommended if biopsy results are not benign, if the nodule is particularly large, or if imaging suggests possible thyroid cancer.
Overactive Thyroid In most cases hyperthyroidism can be treated successfully with medication or radioactive iodine. For some patients however, surgery is the preferred treatment.
Thyroid Cancer Thyroid cancer is becoming more common. Most patients initially notice a nodule or lump in the thyroid. The most common type is papillary thyroid cancer. Treatment involves removal of the thyroid (total thyroidectomy), often with some lymph nodes in the neck. Many patients are also treated with radioactive iodine. Cure rates are very high for most patients with thyroid cancer.
What is involved in Thyroid Surgery?
The two most common operations are removal of the whole gland (total thyroidectomy) or one lobe (hemithyroidectomy). Surgery is performed under general anaesthetic through an incision in the neck, usually 2-3cm above the collarbone. Most patients stay in hospital for 1-2 nights.
All patients who undergo total thyroidectomy and up to 20% of those who undergo hemithyroidectomy will require thyroid hormone replacement. Thyroxine is a tablet taken once daily for life and is usually well tolerated. Thyroid function is checked by blood test 6 weeks after surgery.
What are the risks of Thyroid Surgery?
Although small, there are some risks:
Voice changes The nerves supplying the vocal cords run closely adjacent to the thyroid. A slightly hoarse or weak voice after surgery is not uncommon, often due to swelling rather than nerve damage. Your voice will usually recover over weeks to months. Long-term major voice changes occur in less than 1% of patients. Vocal cord movement is checked before and after surgery with a flexible telescope through the nose.
Low calcium levels (hypoparathyroidism) The parathyroid glands lie adjacent to the thyroid and can be "stunned" after surgery. Calcium levels are checked before leaving hospital. Symptoms include tingling around the mouth, fingers or toes. Approximately 20% of patients require calcium tablets after total thyroidectomy, though most are weaned off these over the following weeks. Less than 1% require long-term calcium supplements.
Bleeding The thyroid has a rich blood supply. Bleeding after surgery is very uncommon (fewer than 1% of patients) but may occasionally require a second operation.
Wound healing problems Most scars heal to a thin line over months. Some people are prone to red and raised scars, which often continue to improve over six to eighteen months.
Any operation with general anaesthetic carries risks including heart problems, lung problems, blood clots, and drug reactions, though serious complications in healthy patients are extremely rare.
It is important that you tell your surgeon and your anaesthetist about any medical conditions or medications prior to surgery.
General Surgery across Lake Macquarie, Newcastle, Hunter Valley, Gateshead
Our surgeons see both public and private patients in the Surgery Central consulting rooms in the Lake Macquarie Specialist Medical Centre and operate in both public and private hospitals.