Thyroid surgery overview
The thyroid is a small gland shaped a like a butterfly. It’s
located in the lower front part of the neck, just below the voice box. The
thyroid produces hormones that the blood carries to every tissue in the body. It
helps regulate metabolism (the process during which the body turns food into
energy). It also plays a role in keeping the organs functioning properly and
helping the body conserve heat.
Sometimes the thyroid produces too much hormone. It may also
develop structural problems, such as swelling and the growth of cysts or
nodules. Thyroid surgery may be necessary when these problems occur.
Thyroid surgery removes all or a portion of the thyroid
gland. A doctor will perform this surgery in a hospital while the patient is under
Reasons for thyroid surgery
The most common reason for thyroid surgery is the presence
of nodules or tumors on the thyroid gland. Most nodules are benign, but some
can be cancerous or pre-cancerous. Even benign nodules can cause problems if
they grow large enough to obstruct the throat, or if they stimulate the thyroid
to overproduce hormones (a condition called hyperthyroidism).
Surgery can correct hyperthyroidism. Hyperthyroidism is
frequently the result of an autoimmune disorder called Grave’s disease. Grave’s
disease causes the body to misidentify the thyroid gland as a foreign body and
send antibodies to attack it. These antibodies inflame the thyroid, causing
Another reason for thyroid surgery is the swelling or
enlargement of the thyroid gland. This is referred to as a goiter. Like large
nodules, goiters can block the throat and interfere with eating, speaking, and
Types of thyroid surgery
There are several different types of thyroid surgery. The
most common are lobectomy, subtotal thyroidectomy, and total thyroidectomy.
Sometimes a nodule, inflammation, or swelling affects only
half of the thyroid gland. When this happens, a doctor will remove only one of
the two lobes. The part left behind should retain some or all of its function.
A subtotal thyroidectomy removes the thyroid gland, but
leaves behind a small amount of thyroid tissue. This preserves some thyroid function.
Many individuals who undergo this type of surgery develop hypothyroidism, a
condition that occurs when the thyroid doesn’t produce enough hormones. This is
easily treated with daily hormone supplements.
A total thyroidectomy removes the entire thyroid and the
thyroid tissue. This surgery is appropriate when nodules, swelling, or
inflammation affect the entire thyroid gland, or when cancer is present.
How is thyroid surgery performed?
Thyroid surgery takes place in a hospital. It’s important not
to eat or drink anything after midnight before your surgery.
When you arrive at the hospital, you’ll check in and then go
to a preparation area where you’ll remove your clothes and put on a hospital
gown. A nurse will insert an IV in your wrist or your arm to administer fluids
Before surgery, you’ll meet with your surgeon. They’ll do a
quick examination and answer any questions you may have about the procedure.
You’ll also meet with the anesthesiologist who will be administering the
medicine that makes you sleep throughout the procedure.
When it’s time for surgery, you’ll enter the operating room
on a gurney. The anesthesiologist will inject medicine into your IV. The medicine
may feel cold or sting as it enters your body, but it will quickly put you into
a deep sleep.
The surgeon will make an incision over the thyroid gland and
carefully remove all or part of the gland. Because the thyroid is small and surrounded
by nerves and glands, the procedure may take two hours or more.
You’ll wake up in the recovery room, where the staff will
make sure you’re comfortable. They’ll check your vital signs and administer pain
medication as needed. When you’re in stable condition, they’ll transfer you to
a room where you’ll remain under observation for 24 to 48 hours.
You may resume most of your normal activities the day after
surgery. However, wait for at least 10 days (or until your doctor gives you
permission) to engage in strenuous activities such as high-impact exercise.
Your throat will probably feel sore for several days. You
may be able to take an over-the-counter pain medication such as ibuprofen or
acetaminophen to relieve the soreness. If
these medications don’t provide relief, your doctor may prescribe narcotic pain
After your surgery, you may develop hypothyroidism. If this
occurs, your doctor will prescribe some form of levothyroxine to help bring
your hormone levels into balance. It may take several adjustments and blood
tests to find the best dosage for you.
Risks of thyroid surgery
As with every major surgery, thyroid surgery carries the
risk of an adverse reaction to general anesthetic. Other risks include heavy
bleeding and infection.
Risks specific to thyroid surgery rarely occur. However, the
two most common risks are:
- damage to the recurrent laryngeal nerves (nerves
connected to your vocal cords)
- damage to the parathyroid glands (glands that
control the level of calcium in your body)
Supplements can easily treat low levels of calcium. Treatment
should start as soon as possible. Notify your doctor if you feel nervous or
jittery or if your muscles start twitching. These are signs of low calcium.