Thyroidectomy

Thyroidectomy is a surgical procedure performed to treat thyroid disorders, such as cancer, non-cancerous growth of the thyroid (goiter) or an overactive thyroid (hyperthyroidism), through the excision of all or a section of your thyroid gland.

What is the Thyroid Gland?

Your thyroid is a butterfly-shaped gland located at the bottom of the front of the neck, along the front of the windpipe.  It produces hormones (made from iodine absorbed from the food we eat) and affects metabolism, growth, development, and body temperature.

When to Consider a Thyroidectomy

A thyroidectomy may be recommended for conditions such as:

An underactive thyroid

An underactive thyroid, also known as hypothyroidism, is a result of the thyroid not producing enough hormones.  Common symptoms of hypothyroidism are fatigue, weight gain, feeling depressed or dry skin, nails and hair.

An overactive thyroid

An overactive thyroid, also called hyperthyroidism, is where the thyroid gland produces too much thyroid hormone.  An overactive thyroid can affect anyone but is more likely to be experienced in women between the ages of 20 and 40.  Common symptoms of hyperthyroidism include feeling irritable, unexplained weight loss, increased heart rate and fatigue.

Nodules

Thyroid nodules are solid or fluid filled lumps that form within your thyroid.  Most of the time, nodules are not serious and your thyroid continues to work normally. The majority of nodules are not cancerous; however, your doctor might take a sample of the cells in the nodule to be sure.  Even benign (not harmful) nodules may cause complications if they become large enough to block the throat.

Noncancerous enlargement of the thyroid (goiter)

Abnormal swelling or enlargement, referred to as a goiter may be uncomfortable but painless and cause difficulty breathing or swallowing.  Like larger nodules, they can obstruct the throat and affect eating, speaking and breathing.

Thyroid cancer

A rare type of cancer that affects the thyroid gland is the most frequent cause for thyroidectomy.  The most common symptom is a painless lump developing in your neck with other symptoms, such as hoarseness or a sore throat, occurring as the condition advances.

Graves’ disease

Graves’ disease is an immune disorder that causes an overproduction of thyroid hormones (hyperthyroidism).  The disease causes your immune system to attack the thyroid gland resulting in inflammation in the thyroid causing it to make more thyroid hormone than your body needs.

Diagnosis

Your doctor will perform an assessment of your symptoms, ask you about your medical history and a physical examination prior to deciding what tests are necessary to diagnose your condition.  They may also carry out a blood test which shows the levels of the thyroid hormone circulating throughout your body.

If you have a nodule, your doctor will take a sample of tissue (biopsy) during the diagnosis appointment to help confirm whether the nodules are cancerous.  You may undergo an Ultrasound to help assess the size and location of the abnormality.

Procedure

A thyroidectomy is usually performed under general anaesthetic, meaning you will be unconscious throughout the procedure and will not feel any pain.  Once you are unconscious, the doctor will make an incision at the centre of your neck, commonly positioned in a skin crease so the scar will be difficult to detect once the incision has healed.  Depending on the type of surgery necessary, all or part of the thyroid gland is then removed.  If you are undergoing surgery due to thyroid cancer, your doctor may also examine the lymph nodes surrounding your thyroid.

A thyroidectomy generally takes 1-2 hours, depending on the extent of the surgery needed.  There are several methods to thyroidectomy, including:

Conventional Thyroidectomy

This technique involves making an incision in the centre of your neck to directly access your thyroid gland.  This approach is the most commonly used.

Thyroid Lobectomy

In some cases, a nodule, swelling or inflammation may only affect half of the thyroid gland.  In this case, around half of the gland is removed, typically through a small incision about an inch in length at the base of the neck.  The part left behind should retain most or all of its function.

Subtotal Thyroidectomy

Subtotal thyroidectomy is a surgical procedure where the doctor removes the thyroid gland but leaves a small amount of thyroid tissue.  This preserves some thyroid function.  In many cases, people who undergo this type of surgery develop hypothyroidism (where the thyroid does not produce enough hormones).  If this occurs, you can take hormone supplements.

Total Thyroidectomy

A total thyroidectomy is a procedure that removes the entire thyroid gland and the thyroid tissue.  This surgical technique is commonly used when nodules, swelling, or inflammation affects the entire thyroid gland, or when cancer is present.

Post-Operative Recovery

In some cases, you may need to have a drain placed under the incision in the neck that is usually removed the morning after surgery.  After a thyroidectomy, you may experience neck pain and a hoarse or weakened voice.  These symptoms are usually temporary and may be caused by the breathing tube that is inserted into the windpipe during the operation, or because of nerve irritation caused by the operation.

Depending on the type of surgery you had, you may be advised to stay overnight in hospital.  When you return home, you can usually resume your daily activities; however, wait at least 10–14 days before taking part in anything vigorous such as lifting or high-impact sport.

Your throat may be sore for several days following the operation but you can take over-the-counter pain medication to help relieve any soreness.  If you are still experiencing pain, contact your doctor.  Hypothyroidism can develop after your surgery; if this occurs, your doctor will provide medication to help balance out your hormone levels.  It takes up to a year for the incision to heal completely and for the scar to fade.

Risks and Complications

Thyroidectomy is generally a safe procedure.  However, as with any surgery, thyroidectomy carries a risk of complications. These include:

• Allergic reaction to general anaesthetic
• Bleeding
• Infection

Other potential complications may include:

• Damage to the parathyroid glands (glands that control the level of calcium in your body) resulting in hypoparathyroidism (low parathyroid hormone levels) caused by damage during surgery or removal of the parathyroid glands. Due to low blood-calcium levels, hypoparathyroidism can cause numbness, tingling or cramping.
• Airway obstruction caused by bleeding, resulting in difficulty breathing.
• Nerve damage causing a permanent hoarse or weak voice.

Treatment for low calcium levels (Hypocalcemia) should start as soon as possible.  Contact your doctor should you feel anxious or if your muscles start twitching.

Outlook after Thyroidectomy

Thyroid removal surgery can treat a range of problems and conditions such as nodules, Graves’ disease or thyroid cancer.  How much of your thyroid gland is removed during thyroidectomy depends on the reason for surgery.  If only a portion is removed, your thyroid may be able to function normally after surgery.  If your entire thyroid is removed, you may require ongoing treatment with thyroid hormone replacement medication.

Your doctor will provide thorough instructions on how best to prepare for your surgery and offer advise a smooth recovery.

Need Help?

At One Healthcare we can book you in to see a specialist ENT Surgeon for an initial consultatioan, usually within 48 hours.  Thyroidectomy is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Thyroidectomy treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Hatfield Hospital.

Why One Hatfield

• Modern purpose-built hospital opened in December 2017
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

Contact us and find out more

If you are based in and around Hertfordshire, St Albans, Stevenage, Watford, North London, Welwyn or Bedfordshire and would like to visit the One Hatfield Hospital please click here.