Procedure guide · Endocrine and head and neck surgery
Thyroid surgery removes all or part of the thyroid gland at the front of the neck. MedlinePlus lists reasons including nodules, thyroid cancer, an overactive thyroid and a goitre that makes breathing or swallowing difficult. After total removal most people need lifelong thyroid hormone tablets. So follow-up at home is part of the plan.
What is thyroid surgery?
MedlinePlus describes total thyroidectomy, which removes the whole gland, and partial thyroidectomy, which removes part of it. It is usually done under general anaesthesia through a horizontal incision low in the front of the neck. A small drain may be placed for a short time. The parathyroid glands, which control calcium, and the nerves to the voice box lie close to the thyroid. That is why surgeons check calcium levels and voice.
Who may be suitable for thyroid surgery?
MedlinePlus lists several reasons. These are thyroid nodules or cysts, thyroid cancer and non-cancerous tumours causing symptoms. They also include an overactive thyroid that is dangerous or unsuitable for other treatment, and a goitre causing breathing or swallowing problems. Whether you need surgery, and how much of the gland to remove, is decided by the surgeon and endocrinologist after tests.
What tests usually come first?
MedlinePlus says imaging such as ultrasound or CT may locate the growth. A fine needle aspiration may show whether it is cancerous. In that test a thin needle collects thyroid cells, often guided by ultrasound. Vocal cord function may also be checked before surgery. Send:
- Thyroid ultrasound reports and images
- Fine needle aspiration cytology reports, and slides if the hospital asks
- Thyroid blood tests with dates
- CT or other scan reports if done
- Notes of any voice changes, swallowing or breathing difficulty
- A full list of medicines, including thyroid medicines and blood thinners
MedlinePlus notes that thyroid medicine or iodine treatment may be given before surgery for some patients. Your endocrinologist will advise.
How should you plan the trip?
- Consultation with the surgeon and endocrinologist, with repeat tests as needed
- Voice check before surgery if advised
- Surgery under general anaesthesia
- Calcium blood tests after surgery, which MedlinePlus says are done more often after total removal
- Discharge once you can swallow liquids, as MedlinePlus describes
- Tissue results, which guide whether further treatment is needed
- Home: thyroid hormone and calcium monitoring with your own doctor
If cancer is found, further treatment may follow. Ask how that would be organised and whether it can be done at home. An attendant is helpful in the first days after surgery.
What should you ask the surgeon?
- Will you remove all or part of my thyroid, and why?
- How will you protect my voice nerves and parathyroid glands?
- Will I need thyroid hormone or calcium tablets afterwards?
- When will the tissue results be ready, and could further treatment be needed?
- When is it safe for me to fly?
- Will you write to my doctor with a plan for blood tests at home?
IndiaMedica helps you share reports and compare written plans. The treating surgeon decides what is suitable.
Questions people ask
Will I need tablets after thyroid surgery?
After total thyroid removal MedlinePlus says most people need lifelong thyroid hormone replacement tablets. After partial removal some people need them and some do not. Your doctor will check blood levels and decide. Make sure you can obtain the medicine at home.
Can thyroid surgery affect my voice?
It can. MedlinePlus lists injury to the nerves of the voice box as a risk, which can change the voice. It also lists low calcium from parathyroid injury, bleeding and anaesthesia risks. Ask your surgeon how they reduce these risks.
Why is a needle biopsy done before thyroid surgery?
MedlinePlus explains that fine needle aspiration collects thyroid cells to help find out whether a nodule is cancerous or not. The result helps the surgeon decide whether surgery is needed and how much of the gland to remove.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.