Head & Neck
The thyroid gland is a vital organ that produces thyroid hormone, a hormone that regulates and maintains the normal metabolic functioning of the body. The thyroid is situated in the middle of the neck in front and on either side (left and right) of the trachea (windpipe).
Thyroidectomy is an operation in which one or both lobes of the thyroid gland are removed.
There are various different Indications or reasons for thyroid surgery:
- Confirmed or suspected thyroid cancer
- To rule out malignancy in the thyroid
- Hyperthyroidism e.g when non-surgical treatment has not been successful or is not suitable
- Enlarged thyroid gland with compressive symptoms e.g. difficulty swallowing
- Enlarged thyroid gland with unacceptable cosmesis
Thyroidectomy surgery is performed under general anaesthesia. The approach to the thyroid gland is usually through a horizontal skin incision made along with one of the skin creases in the neck. Endoscopic approaches using small incisions in the chest wall and axillae (armpits) or via the oral cavity may be an option in some patients.
The thyroid gland is carefully dissected, taking care to identify and preserve vital structures that lie right next to the thyroid gland, in particular the:
- recurrent and superior laryngeal nerves which supply the muscles of the vocal cords
- parathyroid glands which very small glands that produce parathyroid hormone responsible for control of calcium levels in the blood and bone
The extent of surgery depends on pathological examination of tissues removed during the surgery. For example, if the diagnosis of cancer is confirmed in one lobe of the thyroid, your surgeon will proceed to remove the other side as well. The decision to be made at surgery will need to be explained and discussed with you before surgery.
After thyroid surgery, the amount of thyroid hormone produced depends on how much of the gland remains. If only one of the thyroid lobes (left or right) has been removed, most patients will not need to take thyroid hormone replacement. However, patients who have surgery to remove both lobes of the thyroid gland will have to take thyroid hormone replacement for life.