Thyroidectomy

Overview

What is a thyroidectomy?

A thyroidectomy is the surgical removal of all or part of the thyroid gland. Thyroidectomy is just one of the treatments for thyroid disease and is the main surgical treatment for thyroid cancer.

What does the thyroid gland do?

The thyroid, located at the base of your neck, makes a hormone that is sent into your bloodstream. The thyroid hormone controls the speed of your metabolism. The thyroid gland makes this hormone from iodine. Iodine is absorbed from the foods we eat.

The pituitary gland (located in your brain) controls how much thyroid hormone to make. It does this by making thyroid stimulating hormone (TSH). TSH tells the thyroid gland to make more or less thyroid hormone.

What problems can occur with the thyroid gland?

Hypothyroidism: An under-active thyroid is called hypothyroidism. The thyroid produces less thyroxine. This makes the pituitary gland send more TSH into the bloodstream to get the thyroid gland to make more hormone.

Common symptoms of hypothyroidism include:

  • Weight gain
  • Feeling cold
  • Dry skin, hair, and nails
  • Feeling tired

Hyperthyroidism: An over-active thyroid is called hyperthyroidism. The thyroid gland makes too much thyroid hormone. The pituitary gland decreases the amount of TSH in the blood.

Common symptoms of hyperthyroidism include:

  • Heat intolerance
  • Feeling jittery or irritable
  • Fast heart rate
  • Losing weight without dieting
  • Muscle weakness, fatigue

Nodules: Thyroid nodules can be either solid or cystic (fluid filled). Most of the time, your thyroid works normally if you have nodules. Most nodules are not cancerous. However, your doctor might take a sample of the cells in the nodule. This is called a fine needle aspiration. This sample will be examined to make sure there are no cancer cells.

Goiter: This is an enlargement of the thyroid gland. You might feel swelling or enlargement in the neck. It can become larger because your thyroid is trying to make more thyroid hormone. Also, in hyperthyroidism the cells grow faster, which causes the thyroid to grow and make more thyroid hormone than the body needs.

When do I need a thyroidectomy?

Surgery might be necessary to remove a large goiter or nodule. Surgery might also be needed to remove a hyperthyroid gland that cannot be treated with medicine, or for thyroid cancer.

Procedure Details

What occurs during thyroidectomy?

  • You will be given general anesthesia to relax your muscles, prevent pain and make you fall asleep.
  • An incision (cut) is made along a crease in the base of your neck.
  • Your surgeon might remove part of the thyroid (lobectomy), most of the gland (subtotal), or all of the gland (total thyroidectomy).

After the surgery

  • You are usually watched in the hospital overnight.
  • You will have a small scar on the front of your neck.
  • You might be required to take thyroid hormone medication.

Call your doctor if:

  • There is swelling at the incision site.
  • There is bleeding at the incision site.
  • You have a fever of 101 degrees or higher.
  • There is a redness or warmth at the incision site.
  • You experience tingling in your hands, feet, or lips.
  • You notice numbness or tingling in your face, hands, or lips.

Risks / Benefits

What are the risks of thyroidectomy?

The risks of surgery are minimal, but might include:

  • Blood loss.
  • Infection.
  • Injury to parathyroid glands, which can cause low calcium and muscular spasms.
  • Injury to recurrent laryngeal nerve (runs behind the thyroid gland). If injury occurs, patient will experience hoarseness and weak voice.
  • If there is thyroid cancer, you might require additional therapy (radioactive iodine treatment).

Last reviewed by a Cleveland Clinic medical professional on 10/06/2019.

References

  • American Thyroid Association. Accessed 10/30/2019.Thyroid Surgery. (https://www.thyroid.org/wp-content/uploads/patients/brochures/ThyroidSurgery.pdf)
  • American Association of Endocrine Surgeons. . Accessed 10/30/2019.Thyroid Surgery: Types (http://endocrinediseases.org/thyroid/surgery_types.shtml)
  • American Cancer Society. Accessed 10/30/2019.Surgery for Thyroid Cancer. (https://www.cancer.org/cancer/thyroid-cancer/treating/surgery.html)

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