What are the main indications for thyroid removal. How does thyroidectomy affect long-term health. What are the potential complications after thyroid surgery. How to prepare for thyroidectomy and manage recovery.

The Crucial Role of the Thyroid Gland

The thyroid gland, a butterfly-shaped organ nestled in the front of the neck, plays a vital role in numerous bodily functions. Its primary responsibilities include regulating metabolism, energy production, development, and mood. While a healthy thyroid is essential for daily survival, its dysfunction can lead to significant physical and psychological health issues.

In some cases, the surgical removal of the thyroid gland, known as thyroidectomy, becomes necessary. This procedure involves removing either a portion or the entirety of the gland, typically through an incision in the neck, although some newer techniques allow for removal through the mouth.

Common Indications for Thyroidectomy

Thyroidectomy is a significant surgical procedure that doctors recommend only when absolutely necessary. The most common reasons for thyroid removal include:

• Thyroid cancer
• Benign thyroid nodules
• Goiter (enlarged thyroid gland)
• Severe hyperthyroidism

Thyroid nodules, which are growths on the gland, are the most prevalent reason for thyroidectomy. Even when benign, these nodules can cause problems by stimulating the thyroid and leading to hyperthyroidism. In some cases, growing nodules may obstruct breathing, necessitating removal.

For cancerous tumors, thyroid removal is often a crucial step in preventing the spread of cancer throughout the body. In the case of benign nodules, surgeons may opt for either partial or complete thyroidectomy, with the latter generally proving more effective.

Goiter: A Common Culprit

Goiter, characterized by irregular swelling or growth of the thyroid gland, is another condition that frequently requires surgical intervention. This enlargement can cause a visible protrusion on the front of the neck and may lead to difficulties with breathing and eating. Additionally, goiters can trigger many of the symptoms associated with hyperthyroidism.

Immediate Post-Operative Complications

As with any surgical procedure, thyroidectomy carries the risk of certain complications in the immediate aftermath of the operation. These may include:

• Increased bleeding from the throat
• Hypothyroidism (low levels of thyroid hormone)
• Laryngeal nerve injury
• Reduced parathyroid hormone levels
• Numbness in extremities, lips, and surrounding areas
• Seromas (fluid collection under the skin)

Bleeding complications typically occur within a few hours post-surgery and generally subside after a short period. Seromas, while less common, can lead to fever, confusion, and changes in heart rate and blood pressure.

Long-Term Side Effects of Thyroid Removal

While immediate complications are often temporary, thyroidectomy can also result in some long-term side effects that patients should be aware of:

Infection Risk

As with any surgery, there’s a risk of infection following thyroidectomy. How can this risk be minimized? Proper care of the incision site post-operation and ensuring that the healthcare professional follows stringent hygienic practices during surgery can significantly reduce the likelihood of infection.

Scarring

Scarring is a potential long-term side effect, especially when the incision is made in the front of the neck. However, modern surgical techniques typically result in small incisions, making the scar relatively inconspicuous.

Weight Gain

Some individuals may experience mild weight gain following thyroidectomy. Why does this occur? The removal of the thyroid gland leads to a reduction in thyroid hormone production, which can slow down the metabolism. This risk is higher in younger patients and those who underwent surgery for hyperthyroidism.

Voice Changes

A common postoperative issue is hoarseness of the voice, also known as post-thyroidectomy dysphonia. This complication can extend beyond difficulty speaking to include problems with eating and, in some cases, noisy breathing. These symptoms often result from damage to the laryngeal nerve during surgery.

Managing Life After Thyroid Surgery

Following thyroidectomy, patients must adjust to life without a functioning thyroid gland. This typically involves:

1. Hormone replacement therapy: Most patients will need to take synthetic thyroid hormones for the rest of their lives to replace the function of the removed gland.
2. Regular blood tests: Frequent monitoring of thyroid hormone levels is crucial to ensure the replacement therapy is effective.
3. Dietary adjustments: Some patients may need to modify their diet, particularly in terms of iodine intake.
4. Lifestyle changes: Managing weight through diet and exercise may become more important post-surgery.

How long does it take to adjust to life after thyroidectomy? While individual experiences vary, most patients find that it takes several months to fully adapt to their new hormone regimen and lifestyle changes.

Preparing for Thyroidectomy

Proper preparation can significantly impact the success of the surgery and the recovery process. Here are some key steps patients should take:

• Discuss all medications with your doctor, including over-the-counter drugs and supplements
• Follow fasting instructions prior to surgery
• Arrange for transportation home after the procedure
• Prepare your home for recovery, including easy-to-reach necessities
• Stock up on soft foods for the initial recovery period

What questions should patients ask their surgeon before the procedure? Important topics to discuss include the expected duration of the surgery, potential risks specific to your case, and the surgeon’s experience with thyroidectomy.

Recovery Process and Timeline

The recovery process following thyroidectomy varies from patient to patient, but generally follows this timeline:

Immediate Post-Op Period (1-2 days)

Patients typically stay in the hospital for 1-2 days following surgery. During this time, medical staff monitor for any immediate complications and manage pain. Most patients can eat and drink normally within a few hours of surgery.

First Week Post-Surgery

Upon returning home, patients should rest and avoid strenuous activities. Mild pain and discomfort around the incision site are normal. Patients may experience some voice changes or difficulty swallowing, which usually improve over time.

2-4 Weeks Post-Surgery

Most patients can return to work and normal activities within 1-2 weeks, depending on the nature of their job. However, strenuous physical activities should still be avoided. The incision site continues to heal during this period.

1-3 Months Post-Surgery

By this time, most patients have fully recovered from the surgery itself. However, adjusting to hormone replacement therapy may still be ongoing. Regular check-ups and blood tests are crucial during this period to fine-tune medication dosages.

How can patients optimize their recovery? Following the surgeon’s post-operative instructions carefully, maintaining a healthy diet, staying hydrated, and gradually increasing activity levels as advised can all contribute to a smooth recovery.

Advances in Thyroidectomy Techniques

Surgical techniques for thyroidectomy have evolved significantly over the years, aiming to minimize scarring and reduce recovery time. Some of these advanced techniques include:

• Minimally invasive video-assisted thyroidectomy (MIVAT)
• Robotic-assisted thyroidectomy
• Transoral endoscopic thyroidectomy vestibular approach (TOETVA)

These newer techniques often result in smaller or hidden scars and can lead to faster recovery times. However, they may not be suitable for all patients or all types of thyroid conditions.

What factors determine the best surgical approach for a patient? The size and nature of the thyroid problem, the patient’s overall health, and the surgeon’s expertise all play a role in determining the most appropriate technique.

Living with Hypothyroidism Post-Thyroidectomy

After total thyroidectomy, patients will develop hypothyroidism due to the absence of the thyroid gland. Managing this condition becomes a lifelong commitment. Here are some key aspects of living with hypothyroidism:

Hormone Replacement Therapy

Patients will need to take synthetic thyroid hormones daily. The most common medication is levothyroxine, which replaces the T4 hormone normally produced by the thyroid. In some cases, a combination of T4 and T3 hormones may be prescribed.

Regular Monitoring

Frequent blood tests are necessary, especially in the first few months after surgery, to ensure hormone levels are within the correct range. As the body adjusts, these tests may become less frequent but will still be a regular part of ongoing care.

Symptom Management

Even with hormone replacement, some patients may experience symptoms of hypothyroidism. These can include fatigue, weight gain, cold sensitivity, and mood changes. Working closely with an endocrinologist can help manage these symptoms effectively.

Lifestyle Adjustments

Maintaining a healthy lifestyle becomes especially important after thyroidectomy. This includes:

• Regular exercise to boost metabolism and energy levels
• A balanced diet rich in nutrients
• Stress management techniques
• Consistent sleep patterns

How can patients ensure they’re taking their thyroid medication correctly? It’s crucial to take the medication at the same time each day, usually on an empty stomach, and avoid eating or taking other medications for at least an hour afterward. Consistency is key in managing post-thyroidectomy hypothyroidism.

Psychological Impact of Thyroidectomy

While much focus is placed on the physical aspects of thyroidectomy, the psychological impact of the surgery and subsequent hormonal changes shouldn’t be overlooked. Patients may experience:

• Anxiety about the surgery and recovery process
• Depression or mood swings due to hormonal fluctuations
• Body image concerns related to scarring or weight changes
• Stress about lifelong medication dependence

What support systems can help patients cope with these psychological challenges? Support groups, both online and in-person, can provide valuable peer support. Professional counseling or therapy may also be beneficial, especially for those struggling with significant mood changes or anxiety.

Coping Strategies

Developing effective coping strategies is crucial for maintaining mental health post-thyroidectomy. Some helpful approaches include:

1. Education: Understanding the condition and treatment can reduce anxiety and increase feelings of control.
2. Mindfulness and relaxation techniques: These can help manage stress and improve overall well-being.
3. Regular exercise: Physical activity can boost mood and energy levels.
4. Open communication: Discussing concerns with healthcare providers and loved ones can provide emotional relief and practical support.

How can family members and friends best support someone who has undergone thyroidectomy? Offering practical help during recovery, being patient with mood fluctuations, and encouraging adherence to treatment plans can make a significant difference in the patient’s overall well-being.

Nutrition Considerations Post-Thyroidectomy

Proper nutrition plays a crucial role in recovery and long-term health management after thyroidectomy. While dietary needs may vary based on individual circumstances, there are some general considerations:

Iodine Intake

Iodine is a key component in thyroid hormone production. After thyroidectomy, the body’s iodine needs change. In some cases, particularly for thyroid cancer patients, a low-iodine diet may be recommended temporarily. However, once on stable hormone replacement therapy, most patients can resume a normal iodine intake.

Calcium and Vitamin D

If the parathyroid glands are affected during surgery, calcium metabolism may be disrupted. In such cases, calcium and vitamin D supplements may be necessary. Foods rich in these nutrients, such as dairy products, leafy greens, and fortified foods, may also be recommended.

Selenium

Selenium plays a role in thyroid hormone metabolism. While selenium supplements are not typically necessary, including selenium-rich foods like Brazil nuts, fish, and whole grains in the diet can be beneficial.

Balanced Diet

A well-balanced diet that includes a variety of fruits, vegetables, lean proteins, and whole grains is important for overall health and can help manage weight, which may be a concern for some post-thyroidectomy patients.

How does nutrition affect the absorption of thyroid medication? Certain foods and supplements, particularly those high in iron or calcium, can interfere with the absorption of thyroid hormone replacement medications. It’s important to take these medications on an empty stomach and wait before eating or taking other supplements.

Future Developments in Thyroid Treatment

The field of thyroid treatment is continually evolving, with ongoing research aimed at improving surgical techniques, medication efficacy, and overall patient outcomes. Some areas of current and future development include:

Personalized Medicine

Advances in genetic testing and molecular diagnostics are paving the way for more personalized treatment approaches. This could lead to more precise medication dosing and better prediction of individual responses to treatment.

Novel Drug Therapies

Research is ongoing into new types of thyroid hormone replacement medications that may offer better stability or fewer side effects compared to current options.

Improved Surgical Techniques

Continued refinement of minimally invasive and robotic-assisted surgical techniques may further reduce recovery times and improve cosmetic outcomes.

Regenerative Medicine

While still in early stages, research into thyroid regeneration using stem cells could potentially offer alternatives to lifelong hormone replacement therapy in the future.

What potential breakthroughs in thyroid treatment are researchers most excited about? The development of more physiological thyroid hormone replacement options and advancements in thyroid cancer treatment, particularly for aggressive forms of the disease, are areas of significant interest and potential impact.

As research progresses, patients who have undergone thyroidectomy may benefit from these advancements, potentially leading to improved quality of life and more personalized care. It’s important for patients to stay informed about new developments and discuss potential new treatment options with their healthcare providers.

Thyroid Removal Long-Term Side Effects

Content

• Overview
• Main indications
• Side effects of thyroid removal (thyroidectomy)
• Risks
• How to prepare for the surgery
• Life after thyroid surgery: thyroid conditions
• Recovery from surgery
• The lowdown

The thyroid gland is a butterfly-shaped organ located in the front of the neck in humans. It has many functions throughout the body, including metabolism, energy regulation, development, and mood.

In healthy individuals, the function of the thyroid gland helps them survive each and every day. However, its dysfunction can cause significant detriment to physical and psychological health. 

Thyroid removal or thyroidectomy may be required in some cases. This process involves the surgical removal of either a portion or the entirety of the thyroid gland.¹

Thyroidectomies are quite serious and may be required in cases of thyroid cancer, thyroid nodules, and other conditions that are severely detrimental to one’s health. Surgery can occur either through the mouth or, most commonly, through an incision in the neck. 

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There are a few reasons one might receive a thyroidectomy. The most prevalent of which is the presence or growth of nodules on the thyroid gland.

These nodules or tumors are often benign but can still cause many issues. Often, these include stimulation of the thyroid gland, causing hyperthyroidism. If nodules continue to grow, they can cause eventual obstruction of breathing.

Such conditions may need the removal of the thyroid gland. In benign nodules, the thyroidectomy process can be either complete or partial, though complete thyroidectomy tends to be the most effective. 

In cases where these tumors are cancerous, thyroid removal can be a key treatment to prevent cancer from spreading throughout the body.

Individuals who experience a goiter may also need a thyroidectomy. A goiter occurs with irregular swelling/growth of the thyroid gland, appearing as a protrusion on the front of the neck.

This can obstruct the windpipe and cause trouble with eating and breathing. It may also cause many of the issues associated with hyperthyroidism. Goiters are one of the more common thyroid conditions that need surgical intervention.

Other symptoms indicative of hyperthyroidism or other thyroid conditions that may warrant surgery include:²

As with any surgery, thyroid removal has some possible side effects. While some can be troubling, they are often better than the alternative of leaving the thyroid gland as is and letting thyroid-associated problems persist.

Post-thyroidectomy complications

After the thyroid removal surgery, you may notice some complications such as increased bleeding from the throat, lower levels of thyroid hormone (hypothyroidism), a laryngeal nerve injury or wound, and lower levels of parathyroid hormones in circulation.  

The more obvious complications, such as bleeding, tend to occur a few hours after the surgery and typically stop after a short period.

Some people who undergo thyroidectomy can also experience numbness in their extremities, lips, and the surrounding areas post-operation. Sometimes, this is referred to as Hashimoto’s tingling or numbness. 

Seromas can also occur after surgery. Seromas present as a collection of fluid that spreads under the skin. Individuals with seromas experience fevers, confusion, and changes in heart rate and blood pressure.

Thyroid removal long-term side effects

There are some possible long-term side effects of thyroid removal. As with any surgery, there is a risk of infection. But if the incision is properly sanitized and looked after post-operation, this can reduce the risk of infection occurring. 

It is also important to ensure the healthcare professional undertaking your surgery uses proper hygienic practices.

Scarring can be another long-term side effect that some individuals may be concerned about. This is especially likely if the incision occurs in the front of the neck. However, the incision is often small, so the scar is not largely noticeable.

Individuals undergoing thyroidectomy may experience mild weight gain. This is due to the reduction of thyroid hormone being produced by the thyroid gland, which can slow the metabolism down.

The risk for weight gain is higher in those that received the surgery for hyperthyroidism and in younger individuals.

Hoarse voice/laryngeal nerve damage

A common postoperative issue of thyroidectomy is hoarseness of the voice, sometimes referred to as post-thyroidectomy dysphonia. This complication can include not only difficulty speaking but also difficulty with eating and, in some cases, the noisiness of breath.³

This is often due to damage to the laryngeal nerve, a nerve associated with the voice box. Such damage can occur due to error by the surgeon or intubation (tube insertion through the mouth into the windpipe).  

Research has found that presurgery identification of the superior laryngeal nerve by the surgeon can prevent post-thyroidectomy voice hoarseness.⁴

Hypoparathyroidism

Hypoparathyroidism is a condition where levels of parathyroid hormone (PTH) are low. This condition is associated with hypocalcemia, a condition with lowered calcium levels in the blood.⁵

Parathyroid hormone and calcium are closely linked, so lower levels of PTH can cause lowered calcium levels in the blood, which greatly impairs quality of life. 

This condition is most often caused by damage to the parathyroid glands during thyroidectomy. In fact, hypoparathyroidism is the most common long-term complication of this surgery.

However, this condition can be transient, and research has indicated that those with low postoperative PTH tend to recover fairly quickly. Despite this, the return to normal calcium/PTH can take up to a year.⁶

It is important to note that, in some cases, hypoparathyroidism manifests as seizures after the operation.

Thyroidectomy comes with general risks. These include infection and allergic or adverse reactions to general anesthetics. 

As mentioned above, specific risks associated with thyroidectomy, as mentioned above, include laryngeal nerve damage, hypoparathyroidism, bleeding, tingling, and seromas.

A less commonly considered risk of thyroidectomy is its possible effect on the brain. A 2016 study indicated that individuals with acute hypothyroidism after thyroidectomy experience increases in local functional brain connectivity. In simpler terms, this means how connected certain areas of the brain are.⁷

In this case, increases in functional connectivity are associated with increased depressive symptoms and reductions in quality of life. 

If a thyroidectomy is required, your doctor should give you specific information about how you should prepare for the surgery. However, in general, pretesting of the thyroid occurs alongside blood tests and general screening tests to ensure general overall health and recovery are possible.  

Individuals are advised not to eat or drink anything past midnight the day before the surgery. Often, medications can be taken with a small amount of water. 

On the day of the surgery, it is important to wear comfortable clothing and inform your doctor of any recent changes in your health status.

While individuals can experience some complications after thyroid surgery, it is completely possible to experience a normal life without your thyroid gland. Research even indicates that thyroid removal surgery tends to increase the quality of life in individuals compared to pre-surgery.⁸

Complications such as swelling, bleeding, and changes in voice are often temporary, and individuals can live a relatively normal life without a thyroid gland. 

The only noticeable change is likely to be the addition of levothyroxine to your medicine regime after surgery. This medication increases the amount of thyroid hormone circulating in the body.

It allows an individual to have functional levels of thyroid hormone where the thyroid gland has been removed or partially removed and can no longer produce thyroid hormone to natural levels. Generally, this medication is quite effective.

Thyroidectomies are generally considered to be safe. However, the need for follow-up checkups with the doctor is crucial to minimize postoperative complications. Such visits can involve blood tests, consideration of symptoms, and ultrasounds.

Immediately after the surgery, it is recommended that individuals try to leave the wound alone, take a shower instead of a bath, and refrain from smoking cigarettes or vaporizers. Intense physical activity and lifting heavy items are not recommended in the first-week post-surgery.

To ensure the best wound healing, it is important to avoid trauma to the area, keep it out of the sunlight, and take all prescribed medications.

You should contact your doctor immediately if you experience profuse bleeding, temperatures, intense pain, or an adverse medication reaction.

Thyroidectomy is a surgical process where the entire or part of the thyroid gland is removed. Such removal may be warranted in cases of thyroid nodules, thyroid cancer, hyperthyroidism, and goiters.

While these surgeries are generally successful, they have some possible postoperative complications, including hoarseness of voice, hypoparathyroidism, infection, bleeding, depression, weight gain, and hypothyroidism.

How Common Are Side Effects?

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Finding out you need thyroid surgery can be stressful and even scary. The surgery may be recommended because you have thyroid cancer, or it may be done to treat hyperthyroidism (overactive thyroid), an enlarged thyroid (goiter), or thyroid nodules.

Partial or total removal of the thyroid gland is known as a thyroidectomy. If one of the two lobes of the butterfly-shaped gland is taken out, it’s called a partial or hemi-thyroidectomy. If the entire organ is taken out, it’s a total thyroidectomy.

The good news is that thyroidectomies are quite common—more than 150,000 are performed in the US each year—and the procedure is relatively safe. Still, as with any surgery, there can be complications.

Here we lay out some of the possible side effects of thyroid surgery that you may be concerned about, and put each in perspective so you will know what to expect. The first four effects are more common; the last four are rarer. Where possible, we’ve given specific rates for the complication based on data from studies.

My Voice Will Change

It’s not uncommon to experience hoarseness or for your voice to be weak or have a whispery quality after thyroid surgery. These effects are usually temporary, according to Nishant Agrawal, M.D., professor of surgery and chief of Otolaryngology-Head and Neck Surgery at the University of Chicago.

“Most commonly, voice changes are related to swelling from placement of the breathing tube (intubation), and this should improve within a few days after surgery,” he says.

Less commonly, the surgery could injure the nerves that control your vocal cords, known as the recurrent and superior laryngeal nerves. These nerves are located just behind your thyroid gland. If one or both of them is damaged during the operation, it could result in more persistent or even permanent hoarseness and other voice changes, such as difficulty yelling or making high-pitched sounds.

Estimates vary by study, but the risk of permanent nerve damage from thyroidectomy appears to be less than 5%, or fewer than one in 20 people who have the procedure. (In contrast, up to 40% of people will have temporary voice changes.)

Persistent or permanent voice changes are more likely to occur in people who have advanced thyroid cancer or who are operated on by a surgeon who does not do many thyroidectomies.

Depending on the particular injury and its severity, treatment for vocal cord nerve damage might include a referral to a speech or voice therapist or a collagen injection into the affected vocal cord. In some cases, a second surgery may be recommended once you heal from the thyroidectomy, to repair the nerve damage.

I’ll Gain Weight

If you have a thyroidectomy, your body no longer produces enough (or any) thyroid hormones, which in essence causes you to develop hypothyroidism, or underactive thyroid. A common symptom of hypothyroidism is weight gain.

Postoperative weight gain is especially likely if you had a thyroidectomy to treat hyperthyroidism, or overactive thyroid. (Weight gain is actually common after nonsurgical treatment for hyperthyroidism, too.)

However, according to Dr. Agrawal, it’s likely you won’t have significant weight gain once you are on the right dose of thyroid hormone replacement therapy, such as levothyroxine (brand name Synthroid), which is a synthetic form of the hormone thyroxine (T4). This medication generally has to be taken for life after having your thyroid removed, to compensate for the thyroid hormones your body is no longer producing.

It can take some time to find the correct dosage of thyroid hormone replacement for you, but once you do, your metabolism will stabilize and your weight shouldn’t change substantially, Dr. Agrawal says. It’s important to follow up with your endocrinologist and/or primary care doctor after thyroid surgery to check your thyroid hormone levels and adjust your levothyroxine or other hormone replacement medication as needed.

I’ll Have Difficulty Swallowing

There’s a decent chance you will, at least for a bit. Temporary dysphasia, or difficulty swallowing, is common after thyroid surgery, affecting up to 20% of people who have part or all of their thyroid removed.

You may feel like food isn’t going down the way it used to, food gets stuck in your throat, or you choke or gag when you swallow. As with voice changes, “difficulty swallowing is most commonly related to swelling from the placement of the breathing tube (intubation) during surgery,” says Dr. Agrawal. It usually improves within a few days after the procedure.

In some cases, however, swallowing difficulty can persist for months or longer; this could indicate nerve damage from the surgery and often requires treatment.

Treatments for dysphagia can include changes to your diet such as eating soft, moist, mashed fruits or vegetables, yogurt, or soft scrambled eggs. Your doctor may refer you to a speech or occupational therapist for coaching on different postures that make it easier to swallow, or for swallowing therapy that includes exercises to improve the coordination and strength of the muscles and nerves involved with swallowing.

My Calcium Levels Will Drop

Adjacent to your thyroid gland are four small but vital glands called the parathyroids, which produce a hormone (parathyroid hormone, or PTH) that regulates calcium levels in the blood. After a thyroidectomy, some people experience symptoms of low calcium such as burning, tingling, or numbness in their hands, feet, or around the mouth. According to Dr. Agarwal, this can be due to an interruption in the blood supply to the parathyroid glands or the inadvertent removal of the parathyroids during surgery.

People who undergo thyroidectomy to treat an autoimmune thyroid disorder, such as Hashimoto’s thyroiditis or Graves’ disease, are at heightened risk of this side effect, as are those with extensive and advanced thyroid cancer, says Dr. Agrawal.

Fortunately, the disruption in calcium levels can usually be remedied in one to three months by taking daily supplements of calcium and/or vitamin D (which increases calcium absorption), says Maria Evasovich Swenson, M. D., a surgical oncologist at the University of Minnesota Medical School and M Health Fairview.

Once the parathyroid glands recover and parathyroid hormone levels return to normal, the supplements can be stopped. However, you may require lifelong supplementation if damage to your parathyroid is permanent, which occurs in fewer than 5% of cases.

I’ll Have an Unattractive Scar

The location of your scar and its appearance depend not only on the particular technique your surgeon used but also how your body heals.

“In general, thyroidectomy scars heal very well when placed in a natural skin crease,” Dr. Agrawal says, and most surgeons experienced with thyroidectomies are adept at minimizing the chances of unsightly scarring. Still, some people heal with scars that become thick, raised, or dimpled.

To help improve the appearance of your scar, Dr. Agrawal recommends avoiding direct sunlight (which contributes to pigmentation variation) and applying a mineral-based sunscreen containing zinc oxide or titanium dioxide before going outdoors. You can also ask your doctor about using a silicone-based, over-the-counter topical product such as ScarAway, sold as either adhesive sheets or a gel. It can make a scar softer, improving its thickness and its color. You can use the product daily for up to six months.

My Trachea (Windpipe) Will Be Damaged

The trachea, or windpipe, is the cartilaginous tube that connects your larynx, or voice box, with the large airways leading to your lungs. When you inhale, oxygen travels down the trachea. This structure could be accidentally perforated or otherwise damaged during a thyroidectomy, though this happens “very rarely—less than 1% of the time,” Dr. Swenson says.

Those at risk of trachea damage include individuals who had a significantly enlarged thyroid (goiter) or who had surgery for a complex cancer, adds Dr. Swenson. Typically the damage is discovered during the thyroidectomy, but occasionally it isn’t found until after the operation when the patient experiences symptoms such as hoarseness, pain behind the breastbone, or shortness of breath after coughing. Tracheal damage needs to be repaired surgically.

I’ll Experience Dangerous Bruising

Very rarely, blood may pool in the tissues of the neck after thyroid surgery. This bruising, or hematoma, can be painful and is usually accompanied by black-and-blue skin discoloration, swelling, and hardness under the incision or on the side of your neck. Though this side effect is uncommon, occurring in 0.3% of cases, it can be dangerous if it progresses, leading to difficulty breathing or even life-threatening pressure on your airway.

If a hematoma occurs, it’s usually within a day of surgery. A number of conditions increase the risk for a hematoma, including having a bleeding disorder or taking an anti-clotting medication such as Xarelto (rivaroxaban), which you are typically asked to stop taking before surgery. If you notice any of the signs or symptoms above, tell your doctor or the hospital staff right away. Additional surgery is sometimes needed to remove the pooled blood.

My Face Will Look Different

There have been rare reports of individuals experiencing a problem on one side of their face following thyroid surgery, specifically a droopy upper eyelid (ptosis), a pupil that doesn’t dilate (widen) as well as the other eye’s pupil, or the absence of sweating on that side of the face. This is known as Horner’s syndrome (or Oculosympathetic Palsy) and is caused by damage to the sympathetic nerves that run behind the thyroid gland. The risk of this occurring is very low: 0.2%, or about two out of every 1,000 people.

Horner’s syndrome is mainly an aesthetic concern; it doesn’t result in vision defects and often improves within a few months to a year. If the eyelid drooping or other changes don’t resolve on their own, you can talk with your doctor about getting a referral to an ophthalmologist who specializes in ocular plastic surgery.

Yearly Volume of Thyroidectomy: Al-Qurayshi, Zaid, MD, Thyroidectomy: The Surgeon Volume Effect; March 16, 2017, Physician’s Weekly.

Complications From Thyroidectomy: Advanced Biomedical Research. 2019. “Assessment of the Early and Late Complication after Thyroidectomy.”

Weight Change After Thyroidectomy: Korean Journal of Clinical Oncology. 2020. “Weight change in patients with differentiated thyroid carcinoma after total thyroidectomy versus lobectomy.”

Scars From Thyroidectomy: Acta Otorhinolaryngologica Italica. 2021. “Scar satisfaction assessment after conventional thyroidectomy: follow-up results.”

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Thyroidectomy – removal of the thyroid gland

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Indications Contraindications Preparation Surgery Rehabilitation Complications Thyroidectomy at SM-Clinic

Thyroidectomy is a surgical operation that involves complete or partial excision of the thyroid gland. Intervention is one of the main methods of treatment of malignant and benign neoplasms of this organ.

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The most common indications for thyroidectomy are:

• thyroid cancer;
• large benign neoplasms: adenoma, nodes, cysts;
• multinodular goiter;
• diffuse toxic goiter;
• Thyroid nodes that produce hormones (toxic nodes).

Surgery is also indicated in cases where the patient develops cancer, but there are contraindications for radioiodine therapy.

Contraindications

Intervention is low-traumatic and therefore has a minimum number of contraindications. Thyroidectomy is not performed if the patient is found to have:

• acute infectious diseases;
• chronic pathologies in the acute stage;
• blood clotting disorders.

Preparation

As part of the preparation, you need to undergo a comprehensive examination, which includes:

• consultation with the attending physician;
• consultation with an anesthesiologist;
• blood tests, including coagulogram;
• urine tests;
• electrocardiogram.

If necessary, additional laboratory or instrumental studies, consultations with highly specialized specialists are prescribed.

Tell the doctor in advance about the medications the patient takes regularly. It is important to inform about the presence of allergies. As part of the preparation, a course of antibiotics may also be prescribed.

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Operation

Any type of thyroid surgery is performed under general anesthesia. The patient is put into a state of sleep and does not feel anything during the operation.

After the anesthesia has taken effect, the surgeon makes a transverse incision at the base of the neck. The incision is made in such a way that in the future the scar merges with the skin fold and is as inconspicuous as possible. After that, depending on the goals of the operation, the surgeon removes the pathology along with the thyroid gland or part of it. One of the main goals is to preserve the parathyroid glands and the recurrent nerve, if they are not affected by the disease.

After removing the tissues, the surgeon sews up the wound, puts a drain. Depending on the extent of the surgeon’s actions, the operation takes from 45 minutes to 3 hours.

Rehabilitation

After the intervention, you must stay in the hospital under the supervision of medical staff. Pain in the neck and throat persist for several days. Painkillers prescribed by a doctor help to get rid of pain.

The term of hospitalization is determined individually and depends on the volume of surgical intervention, the patient’s well-being. Often, after 2-3 days, discharge and continued recovery at home is possible.

If a total thyroidectomy, that is, the total removal of the thyroid gland, has taken place, a person will develop hypothyroidism after the operation. Therefore, there will be a need for a lifelong intake of hormonal drugs. However, even in the case of not total, but partial thyroidectomy, the thyroid gland may also lose its functions, which will have to be replenished with the help of drugs. Despite lifelong hormone replacement therapy, after recovery, a person will be able to lead a normal life without uncomfortable restrictions.

Complications

Complications after the intervention are quite rare. Among the most common: postoperative bleeding, hypoparathyroidism (lack of calcium in the body). If the laryngeal nerve is damaged during the operation, the timbre of the voice changes. Restoration of the usual timbre takes from 3 to 12 weeks. The risk of nerve damage is less than 1%.

Thyroidectomy at SM-Clinic

Surgical intervention on the thyroid gland refers to technically complex operations. The result of such treatment largely depends on the skills of the doctor. To minimize the risks and achieve the maximum positive effect, therapy should be trusted only by experienced surgeons who are proficient in advanced operating techniques. These are the doctors who work in the SM-Clinic.

We have been operating on patients since 2009. Our doctors perform more than 8500 operations annually in 20 surgical directions. Our team consists of over 140 experienced operating doctors and 18 anesthesiologists, including 20 doctors and candidates of medical sciences.

On the basis of our clinic in St. Petersburg, you can undergo a comprehensive preliminary examination. Our patients have at their disposal 7 operating theaters with modern equipment and 25 comfortable hospital wards.

Call us at the phone number listed on the website to find out the price of thyroidectomy, get acquainted with the price list for other services or sign up for a consultation.

* You can find out more about the conditions here – Treatment on credit or installments

Preliminary cost. The exact cost of the operation can only be determined by the surgeon during a free consultation.

Specialists in this field 5 doctors

Leading doctors 1 doctor

Mikhailov Aleksey Gennadievich

Surgeon, oncologist, mammologist, endocrine surgeon

Work experience: 22 years

Udarnikov, 19

Ladozhskaya metro station

Marshala Zakharova, 20

Leninskiy pr-t metro station

Vyborgskoe shosse, 17

Prosveshcheniya metro station

Make an appointment 90 003

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+4 doctors

Other doctors 4 doctors

Boyko Alexander Aleksandrovich

Oncologist, oncodermatologist “SM-Clinic”

Work experience: 12 years

Dunaysky, 47

Dunayskaya metro station

Make an appointment

Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

m.
Pfanenshtil Anatoly Viktorovich

Surgeon, mammologist and oncologist. Doctor of the highest category.

Work experience: 15 years

Dunaisky, 47

Dunayskaya metro station

Malaya Balkanskaya, 23

m. Kupchino

Make an appointment

Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 years

Vyborgskoe shosse, 17

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Our offices in St. Petersburg

6 branches

Center for Surgery Dunayskaya metro station

Dunaisky avenue, 47

Dunayskaya metro station

daily from 09:00 to 22:00

Center for Surgery Ladozhskaya metro station

Udarnikov Avenue, 19/1

Ladozhskaya metro station

daily from 09:00 to 22:00

Center for Surgery Metro station “Leninsky Prospekt”

st. Marshal Zakharov, d.
daily from 09:00 to 22:00

Center for Surgery Prospekt Prosveshcheniya metro station

Vyborgskoe shosse, 17/1

Prospect Prosveshcheniya metro station

daily from 09:00 to 22:00

Center for Surgery Kupchino metro station

Malaya Balkanskaya street, 23

Kupchino metro station

daily from 09:00 to 22:00

Center for Surgery Dybenko Street

Dybenko Street, 13k4

m. Dybenko street

daily from 09:00 to 22:00

Total thyroidectomy

is an operation to completely remove the thyroid gland. Our medical center employs qualified surgeons with many years of experience. Therefore, total thyroidectomy is performed with minimal risk to the patient.

Advantages and disadvantages of the treatment method

The thyroid gland produces iodine-containing hormones that regulate the metabolism and growth of certain body cells. Many patients rightly fear that the removal of the organ will provoke serious health problems. To avoid this, lifelong hormone replacement therapy is necessary after the operation.

After total thyroidectomy, the patient is prescribed the same hormonal preparations as after other methods of surgical treatment. This is the main disadvantage not only of the operation to completely remove the thyroid gland, but also of other methods of surgical intervention.

Meanwhile, thyroidectomy has a number of advantages over less radical methods.

1. The operation is performed by an experienced surgeon, so postoperative complications are rare.
2. Compared to lobectomy, cancer relapses are much less common.
3. The likelihood of developing distant metastasis is reduced by four times.
4. Mortality in patients with poor prognosis is halved.
5. Increases the effectiveness of treatment in the postoperative period.

In patients after total thyroidectomy, the sensitivity to radioiodine diagnostics and the specificity of thyroglobulin detection increase. This allows doctors to detect distant metastases at an early stage and start treatment in a timely manner.

Indications and contraindications for total thyroidectomy

Endocrine surgeons of our medical center follow the indications for surgical treatment of thyroid pathologies. Total thyroidectomy is performed for all forms of thyroid cancer, including well-differentiated carcinomas.

In nodular goiter, if conservative treatment fails, the physician may also decide to perform a total thyroidectomy. In this case, the indication may be:

• confirmation of carcinoma by cytology;
• neoplasms, if malignant is suspected;
• complex cytomorphological diagnostics;
• compression of the neck organs by a large tumor;
• multinodular goiter
• development of thyrotoxicosis.

At the discretion of the surgeon, a patient with Graves’ disease (diffuse toxic goiter) may be referred for an operation to remove the thyroid gland. Recent studies have shown the ineffectiveness of subtotal (partial) removal of the gland in this disease due to the high incidence of recurrence of thyrotoxicosis.

A temporary contraindication is the presence of a concomitant disease in an acute form or in the stage of exacerbation of a chronic course. In this case, the patient is prescribed the necessary treatment. After the onset of the remission stage, thyroidectomy can be performed.

Preparing the patient for surgery

Patients of our medical center undergo a mandatory preliminary examination. To determine the appropriateness of surgical intervention, the patient is sent for instrumental diagnostics and testing for laboratory tests. An ultrasound is performed and according to the indications of an MRI of the thyroid gland, an ECG, a general and biochemical blood test is given. Other diagnostic methods may be used at the discretion of the physician.

Before surgery, the patient is seen by a doctor who makes recommendations regarding diet and other aspects of preoperative preparation. If the patient is taking any medication, the doctor must know about it. To eliminate thyrotoxicosis, antitherodine drugs are prescribed. This measure helps to avoid thyrotoxic crises after the operation.

On the eve of the appointed day, it is recommended to eat until 19-00, drink liquids until 23-00. On the day of the operation, it is only possible to take light liquids (water, tea) 5 hours before the operation.

Operation and post-operative period

The operation is performed under general anesthesia and lasts 1-2 hours. During the surgical intervention, the patient’s physiological parameters (pulse, respiration, etc.) are monitored using modern medical equipment.

The incision is made along the front surface of the neck, or in the sternum area along natural skin folds, taking into account the aesthetic component. In this case, postoperative scars are almost invisible. If the patient has thyroid cancer, the surgeon may also remove the lymph nodes adjacent to the organ.