The thyroid gland is in the lower part of the neck and lies either side of the trachea (windpipe). It makes thyroid hormone, which is responsible for controlling our metabolic rate. Too much thyroxine (hyperthyroid) causes loss of weight, sweating, palpitations, diarrhoea and tremor. Not enough (hypothyroid) causes weight gain, lethargy, low blood pressure and constipation. A simple blood test can determine the level of thyroxine. Occasionally growths (both benign and malignant) can occur in the thyroid gland. This is a reason for thyroid surgery (thyroidectomy)
What is thyroidectomy?
Thryoidectomy is an operation to remove one side of the thyroid gland (a hemithryoidectomy) or all of the thyroid gland (a total thyroidectomy).
Why have a thyroidectomy?
The most common reason is to remove a lump in the thyroid gland. This is advised if there is a big lump in the thyroid gland, or if preoperative tests (ultrasound +/- Fine needle aspirate) indicate that the lump should be removed. Difficulty swallowing, pressure sensation in the neck and an unsightly anterior neck lump can be further reasons for removal. Occasionally an uncontrolled overactive thyroid gland is also removed surgically. (see thyroid problems).
How is the operation done?
You will be asleep. A cut is made in the front of the neck, lower down closer to collar bone. The muscles covering the front of the thyroid are moved aside. The superior thyroid artery is tied and divided. Next the nerve that supplies the voice box is located, and traced to where it enters the voice box. This makes sure the nerve is preserved and that there is no long term voice change after surgery. The inferior thyroid artery is divided and then the gland is removed (from one side). The operation is repeated on the other side of the neck if indicated. There are very small glands behind the thyroid gland called the parathyroid glands. They are responsible for control of calcium in the body. Ideally these are preserved. A plastic drainage tube is inserted under the skin to remove any blood that may collect there. The skin is then closed.
After the operation:
You will remain in hospital until there is minimal blood going into the drain. Commonly people go home on the second day after surgery. The clips or stitches are removed about 5-7 days after the surgery. It takes about one week to get the result back from the laboratory. Only if you have had all the thyroid gland removed do you need to take replacement thyroxine hormone. You will need two – three weeks off work.