Thyroid surgery is a common procedure used to treat several conditions of the thyroid, the butterfly-shaped gland located in the neck. Surgery can remove part or all of the thyroid gland, depending on the type and severity of the condition.
Thyroid surgery is often used to treat:
- Thyroid cancer
- Thyroid nodules
It is used most often for thyroid cancer, and is seen as a last resort for other conditions. The procedure is performed through an incision in the neck, although minor procedures can sometimes be performed through endoscopy. After undergoing thyroid surgery, most people need thyroid hormone medication for the rest of their lives.
Below are images of an actual thyroid surgery.
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by Jason S. Hamilton, MD, and Ryan F. Osborne, MD, FACS
A 44-year-old woman with complaints of globus sensation and mild compressive symptoms presented for evaluation of multinodular thyroid disease. She denied shortness of breath, hoarseness, weight changes, and palpitations. On physical examination, she had a palpable right thyroid mass. Both true vocal folds were mobile on laryngoscopy. Ultrasonography of the thyroid identified two nodules in the right lobe: a 2.4-cm mass in the superior pole and a 3.0-cm lesion in the inferior pole. A 1.1-cm nodule was also noted in the left thyroid lobe. Fine-needle aspiration biopsy was nondiagnostic.
The patient was offered either a total thyroidectomy or a right hemithyroidectomy followed by a completion thyroidectomy if any malignancy was found. She was unwilling to undergo total thyroidectomy, partly because of concerns about acquiring an unsightly cervical scar. Therefore, a right hemithyroidectomy was performed as an outpatient procedure via a minimally invasive endoscopic approach (figure 1). The following day, she returned to the office for removal of a closed suction drain. Subsequent follow-up visits revealed excellent postoperative results with regard to calcium levels, voice quality, and wound healing (figure 2).
The indications for and limitations of minimally invasive endoscopic thyroidectomy are currently being delineated, and they will continue to evolve as instrumentation improves and experience is gained. In the past, large anterior cervical scars were unavoidable in the surgical treatment of thyroid disease. But as minimally invasive techniques for thyroidectomy are refined, head and neck surgeons will be able to provide good surgical care and achieve better cosmetic outcomes with potentially less morbidity and shorter recovery periods.