Choosing a surgeon to treat your medical condition is an important decision that can significantly impact the outcome and success of your procedure. While surgeons may be fully licensed and certified to perform your procedure, this does not ensure their skill level and experience in performing your individual procedure. Effective results will be best achieved by a surgeon who is comfortable with this type of procedure and has proven his/her skills through previous procedures.
Below are some mistakes many patients make when seeking a surgeon for their thyroid tumor.
1. Not getting a second opinion.
The initial diagnosis of a thyroid mass is typically made by your primary care physician or endocrinologist. He or she may then refer you to a surgeon. This initial referral is often based on factors such as personal relationships between doctors, location of the surgeon, and insurance issues, rather than the technical skill of the surgeon. You owe it to yourself to obtain a non-biased second opinion. Your insurance company is required to pay for your second opinion evaluation, so you owe it to yourself and your family to get one.
2. Not appreciating the risk of vocal cord paralysis.
There is a risk of vocal cord paralysis during thyroid surgery. If one vocal cord is paralyzed, you will have a hoarse voice. If both vocal cords are paralyzed, you will need a permanent tracheostomy tube to breathe. Although these complications are rare, they can occur.
Normal Vocal Cords
Paralyzed Left Vocal Cord
Seeking a consultation with an experienced head and neck surgeon minimizes these risks. Why? Head and neck surgeons are board certified to operate on every structure within the head and neck area, including the vocal cords, voice box, esophagus, and pharynx. All of these structures are at risk while performing thyroid surgery. During your second opinion evaluation, choose a surgeon that is comfortable working on and around all the structures in your neck. You should also have a video examination of your vocal cords prior to your procedure to establish their baseline function.
3. Not addressing the risks of unsightly scarring.
Most surgeons have little regard for the length or postoperative appearance of the thyroidectomy scar, despite the fact that the scar lies in the most visible area of the neck and the fact that most patients are women. In addition, few surgeons recognize the fact that the lower neck and upper chest skin has a higher propensity to develop keloids and hypertrophic scars. Therefore, preventative wound care is essential.
4. Not considering the risk of a thyroid nodule being cancer.
Although most thyroid masses (nodules) are benign, some patients have a true case of thyroid cancer. When making your appointment to see a physician for a second opinion, remember that thyroid cancer is best managed by a surgical team that is fellowship trained in head and neck oncology.
5. Being treated by a surgeon who is not qualified to treat thyroid cancer.
Although many surgeons are comfortable treating benign thyroid disease, few are trained to treat thyroid cancer. Thyroid cancer can spread to the lymph nodes in the neck, requiring a lymph node neck dissection where the lymph nodes that surround the jugular vein, carotid artery, and vagus nerve (responsible for swallowing, speaking, and taste) are removed from the neck. The decision to do a lymph node dissection is often made during the operation and cannot always be decided beforehand. This leaves the inexperienced surgeon in an uncomfortable position during your surgery. Remember that this is not an operation that general surgeons or a general ENTdoctor performs routinely.
Ask your physician during your second opinion appointment how many neck dissections they perform yearly. The number should be over 40.
The first step is to call or e-mail our patient care consultant, Noelia Fedi, and request a preliminary Phone Consultation with Dr. Osborne.
Our patient care coordinator will provide you with the specific forms you need to fill out before your visit. For more information, please contact our patient coordinator at (310) 657-0123.
Please provide clear, recent close-up profile (on the side of lesion) and full face photos. Photos should clearly show your area of concern and can be sent by FedEx or e-mailed.
Obtain an Evaluation
Dr. Osborne will review your history, physical exam findings and all reports, review your films and photographs, and discuss reconstructive options with Dr. Hamilton. Dr. Osborne will then discuss all your options with you, and together you will come up with a customized treatment plan. You will then be contacted by our Patient Care Consultant who will discuss pre-operative care, costs, recovery, local accommodations and any questions related to your procedure(s).
Schedule Your Procedure
Once you have decided to proceed, we will reserve your surgery date.
Read, Initial, Sign
Shortly after your surgery is scheduled, you will receive a packet in the mail containing pre-operative instructions and procedure consents. These documents must be read carefully and all instructions followed closely. All contents must be signed and initialed. The entire pre-operative packet must be brought with you to your pre-operative office visit. If you have any questions at this time, please do not hesitate to call or email the office for clarification.
At the Institute, Dr. Osborne and Dr. Hamilton perform all of your surgery from start to finish, meaning that a head and neck oncologist performs your tumor removal and a facial plastic surgeon performs your wound closure and reconstruction.
Fly in for Surgery
Our local international airport is LAX. We are located approximately 20 minutes from LAX. You MUST arrive one to two days prior to your surgery date. At a designated time during this period, you will meet with the doctor(s) and have an in-depth consultation discussing all procedures. All consents should be signed and dated for the pre operative appointment. If you have any questions, please do not hesitate to call or e-mail our office.
These hotels are located close to our office at Cedars Sinai Medical Towers, and are the most convenient for appointments, surgery, and follow-up. We have also had positive feedback about these locations from our patients.
- Four Seasons Hotel Los Angeles at Beverly Hills
- Hotel Sofitel
- Beverly Terrace
- Carlyle Inn
- Residence Inn by Marriott-Beverly Hills
- Wilshire Crest Inn
We advise all patients that fly-in for surgery to spend at least the first night in a local hotel or after-care facility, thus ensuring any required medical attention necessary. In the days that follow we will see you post-operatively and, depending upon the procedures that have been performed, you may return home within a few days. In the event that you require any medical attention after returning home, we will refer you to a local physician for a check-up. Your health and safety remain our number one priority. We look forward to meeting you and assisting in your care.