Thyroid Gland

The thyroid gland in the lower neck produces a hormone named Thyroxine. This is necessary for function of most cells in the body. Certain abnormalities of the thyroid gland may bring you to see Dr Nicholson.? You may be referred from your GP or an Endocrinologist (a specialist doctor dealing with medical treatment of thyroid disorders) due to an over activity of the gland (hyperthyroidism), or due to lumps in the gland concerning for cancer, or a general overgrowth of the gland causing pressure in the neck (goiter).?

Evaluation of these problems may require an ultrasound, and possibly the insertion of a needle to aspirate fluid or cells from lumps within the gland (FNA). If this is required it is usually done in association with an ultrasound examination.

On many occasions, the results of the ultrasound and FNA may be reassuring, and review is all required.

Surgery of the Thyroid Gland –Thyroidectomy

If an interpretation of the cells is not possible, or if cancer cells are found, an operation on the thyroid may be recommended. This may take the form of removing half of the thyroid gland? (hemithyroidectomy), or total removal (total thyroidectomy) if the gland is causing pressure on the windpipe or if cancer is found on the FNA.

It is important to bring any thyroid related blood tests or ultrasound and CAT scan tests you may have had done through your GP or specialist Doctor to your consultation.

Dr Nicholson performs operations on the thyroid gland about 3 or 4 times per week and has trained in the United States in all aspects of surgical treatment in thyroid disease. The procedure takes between 1 to 2 hours, and requires at least one night convalescing in hospital with 1 to 2 weeks off work required depending on occupation.

Possible Complications and Risks

Complications are rare, but entirely possible and need to be discussed carefully with Dr Nicholson. The most common is injury to the laryngeal nerve, which causes a change to the voice.? If this occurs it is usually temporary. Rarely it is permanent, and if so may require a minor operation to correct it (vocal cord augmentation). In operations involving removal of the entire gland (total thyroidectomy), injury to small glands behind the thyroid (the parathyroid glands) may result in reduced calcium levels in the blood. This may be temporary or permanent. If permanent, life long supplementation with calcium supplements will be required. Again, Dr Nicholson will discuss any potential complications with you.

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All patients undergoing thyroid surgery will have a neck scar, placed in a skin crease and closed using plastic surgical techniques. In some people predisposed to a condition called keloid, this scar may remain prominent and obvious.

In those patients undergoing removal of all the thyroid gland (total thyroidectomy) the loss of the production of thyroxin will need to be replaced by a daily tablet medication for life.? Conserving half of the thyroid (i.e. hemithyroidectomy) usually provides enough thyroxine from the remnant to provide sufficient thyoxine without supplementation.

Instructions for Surgery for Thyroidectomy

You may also refer to the Preparing for Surgery patient information sheet.

FASTING: (food & liquid) from midnight for a morning operation and from 7.30am for an afternoon operation, a light breakfast of tea and toast is OK prior to 7.30am.? Children under 14 may have clear fluids only up until 10.30am, (NO MILK) but definitely nothing after 10.30am.

FORMS: Hospital admission forms and anaesthetic forms should be completed and returned to the hospital at least 3 days prior to the date of your operation.? If you have any queries regarding your operation please do not hesitate to contact Dr Nicholson’s rooms.

Postoperative care for Thyroidectomy

Most patients will be discharged following the day of surgery. The neck wound although waterproof, should be kept dry.

Only patients requiring a total thyroidectomy will require thyroxine tablets. Often this is not prescribed until after the pathology has been obtained on the surgical specimen.

Calcium supplements may occasionally be required in the early post operative period following total thyroidectomy.

A review appointment will normally be scheduled for one week following discharge.

Care to avoid heavy coughing or straining or lifting for several days after discharge.

*These notes are an outline only and should be expanded on in discussion with Dr Nicholson.

The patient information sheets are intended as a guide only and not to take the place of a full discussion of this procedure with Dr Nicholson

Head and Neck Cancer Surgery
Preparing for Surgery

Illustration Credit: Royal Australasian College of Surgeons & Mi-tec.
The complete College patient education pamphlet is available from your surgeon.

ENT specialist | Head and Neck surgery | Head and Neck cancer | Rhinoplasty | Grommets | Tonsillectomy | Parotidectomy
Functional Endoscopic Sinus Surgery (FESS) | Sinusitis | Parathyroidectomy | Thyroid/Thyroidectomy

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