Thyroidectomy
The thyroid gland is an H-shaped gland just in front of the larynx. This gland secretes thyroid hormone, which is essential for normal health. Thyroidectomy is a procedure to partially or totally remove the gland. Reasons for doing this surgery may include a mass or tumor involving the gland, an overactive thyroid gland, or difficulty swallowing because of an enlarged gland. The procedure is performed at the hospital under general anesthesia. The extent of the surgery depends on the underlying pathology. If there is a known or suspected malignancy, the entire gland is removed (total thyroidectomy). If there is a mass of unknown type involving one side, then that side is removed and immediately sent to the pathologist who renders a preliminary diagnosis. If it is benign, then the other side is left untouched to minimize risks. If it is found to be cancerous, then the rest of the gland and surrounding lymph nodes are removed. However, on occasion the pathologist is unable to tell if the lesion is cancerous until final results are available days later. Then, if cancer is found in the specimen, it would be necessary to return back to the operating room for a completion thyroidectomy. Special mention is made to important structures near the thyroid gland, the parathyroid glands and the recurrent laryngeal nerves to the voice box. The parathyroid glands are very small and vary in number (4-6) and location (anywhere from the back of the throat to the upper chest; typically they are near or even inside Dr. Speyer will discuss the risks, benefits, and alternatives to this procedure with you in detail. Listed below are some of the disclosed risks of undergoing a thyroidectomy. By reading and signing below, you are stating that you indeed understand the nature of the procedure, the risks as listed, and alternatives to undergoing the procedure. Risks of thyroidectomy include, but are not limited to, bleeding, infection, recurrent laryngeal nerve weakness or paralysis resulting in difficulty with voice and swallowing which may be temporary or permanent. Additional therapy and/or surgery would be recommended. In rare instances, both nerves are injured requiring a tracheotomy, which may be temporary or permanent. Malignancies carry the risk of recurrence, failure to clear all of the margins with residual tumor left behind, and the need for additional treatment such as iodine radiotherapy. There is a risk of temporary or permanent hypocalcemia. If a neck dissection is performed as well, this carries with it additional risks of nerve injury, shoulder dysfunction, chyle leak, damage to surrounding veins and/or arteries. All incisions carry the risk of scarring or keloid formation, which will be minimized by hiding the incision in a skin crease and using fine sutures to result in the most acceptable cosmetic outcome. Lastly, since you are undergoing a general anesthetic, this alone carries its own risks regardless of the surgery considered. The risks of general anesthesia include, but are not limited to, the risk of heart attack, stroke, drug reactions, and even death. You should discuss your specific risks assessment with the anesthesiologist during your preoperative anesthetic appointment.
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the thyroid). The parathyroid glands are important in calcium regulation of the body. During thyroidectomy, the parathyroid glands could be removed or damaged resulting in low calcium (hypocalcemia) necessitating calcium and Vitamin D supplementation post-operatively. This may even be a permanent situation. Second, the recurrent laryngeal nerves pass from the brain, down the neck along the large arteries, and then turn around and come back up along the windpipe and thyroid gland before reaching the larynx where they control the motion of the vocal cords on each side. These nerves will be identified and kept safe throughout the procedure. Rarely, tumors invade these nerves necessitating their resection as well as the thyroid gland. 