What is thyroidectomy or thyroid surgery?

Thyroid surgery may be done to treat an enlarged thyroid, or it may be done to remove a lump.

It may also be done to treat an overactive gland, or it may be done to treat a gland that may have cancer cells.

What is a thyroid gland?

The thyroid gland is located in the front of the neck and sits below the voice box. The small, two-inch gland consists of two lobes, one on each side of the windpipe, connected by a small bridge of thyroid tissue called the isthmus.

The thyroid tissue is made up of two types of cells: follicular cells and parafollicular cells. Most of the thyroid tissue consists of the follicular cells which secrete the iodine-containing thyroid hormones; they consist of thyroxine (T4) and triiodothyronine (T3). The parafollicular cells secrete the hormone calcitonin; in humans, calcitonin has only a minor role in calcium regulation.

The thyroid plays an important role in regulating the body’s metabolism. Nearly every tissue in the body is affected or regulated by the thyroid hormone including the brain and nerve development and function, skin, hair, eyes, heart, and intestine function. The thyroid hormones enter into tissues and regulate how those tissues produce or do not produce certain problems.

The thyroid function is controlled by the pituitary which sits at the base of the brain and is controlled by a region in the brain called the hypothalamus.

What to expect with a thyroidectomy

Getting ready for thyroid surgery

  • You may need to stop taking some medications, including aspirin and other blood thinners, herbs and other supplements.
  • Do not eat or drink anything for 12 hours before the surgery.

During the thyroid surgery

  • An IV will be inserted in your arm or hand to give you fluids and medicine during the surgery.
  • You’ll be given general anesthesia to keep you asleep and free of pain through the surgery.
  • An incision is made in your neck along the crease in your skin.
  • Half of the thyroid gland may be taken out; this is called a lobectomy, or most of the gland may be taken out called a subtotal thyroidectomy. In some cases, all of the glands is taken out called a total thyroidectomy. Your surgeon may not know how much to take until the surgery.
  • The incision is then closed with surgical strips, clips or stitches. A thin tube may be left in the incision to help remove fluid that can build up.

After the thyroid surgery

  • It may take a few hours for the anesthesia to wear off. You'll get up and walk around soon after the surgery, and you'll be monitored for bleeding.
  • You may spend some time staying in the hospital or surgery center after the surgery.
  • In most cases, you can eat and drink the evening after surgery, and you may still have nausea from the anesthesia.
  • You'll be given medicine to help manage the pain if needed.
  • You'll be tested to make sure your parathyroid glands are still working; the stress of surgery may stop them from working for a short time. If this happens, you may be given calcium pills for a few days.
  • You may have a sore throat and a hoarse voice for a week or so after the surgery.

Risks and possible complications of thyroidectomy

  • Bleeding
  • Infection
  • Damage to nerves in your voice box, which can lead to a hoarse voice. Usually, the hoarseness gets better over time, though in rare cases it may last
  • Damage to the parathyroid glands or their blood supply, which can make them underactive. These glands control the amount of calcium in your blood. Usually, the hypoparathyroidism gets better over time, but you may need to take daily calcium pills for a long time—or for the rest of your life. You may also need to take vitamin D supplements