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Part or all of the thyroid gland, which is located in a front of the lower neck, above the windpipe, may need to be removed. This may be due to enlargement of the thyroid or other disease of the thyroid such as a tumour.
The thyroid gland consists of a right and left lobe and usually is around 6-7 cm in size and sits above the trachea (windpipe) in the front of the neck. It produces the hormone thyroxine which is responsilble for controlling the body's metabolic rate. In other words, it keeps the many processes of the body working to the correct level.
However, if the thyroid produces too much thyroxine, then the body becomes over active and this places a strain on several other organs including the heart and circulation. This condition is called hyperthyroidism or thyrotoxicosis.
Alternatively, if the thyroid produces too little thyroxine, then the body becomes underactive and starts to fail. This condition is called hypothyroidism or myxoedema.
If the thyroid swells, it can compress on the windpipe or produce an unsightly swelling of the neck, sometimes called a goitre. In this case, a thyroidectomy operation is done to partially or completely remove the thyroid. To compensate for the lower thyroxine or the complete lack of thyroine that will therefore be produced after surgery, the patient is given thyroxine tablets for the rest of their life.
This operation is done under general anaesthesia. An incision is made across the front of the neck, usually in the skin folds to produce the best cosmetic effect after surgery. The relevant portion or lobe, or the whole gland is isolated and removed, avoiding several very important structures in the neck such as the parathyroid glands (which control the bodies calcium levels) and nerves such as the one that controls the voice box or larynx. The wound is then stitched and covered by a dressing.
Symptoms of an over-active thyroid gland include;
- increased appetite
- weight loss
- lethargy and tiredness
- insomnia or an inability to sleep well
- more frequent bowel movements with or without diarrhoea
- reduced or infrequent periods in women
- irritability
- emotional changes
- intolerance of hot weather
- sweating
- itching
- a fast pulse or palpitations in the chest
- tremor
- shortness of breath and chest pain, especially in elderly patients.
Symptoms of an under-active thyroid include;
- nothing
- weight gain
- constipation
- intolerance to cold weather and temperatures
- heavy or more frequent periods in women
- hoarse voice
- lack of energy
- depression and emotional problems
- stress and anxiety problems
- dry skin and hair
- a slow pulse
- swelling of some soft tissues such as around the eyes, hands or feet
- dementia especially in the elderly.
Complications such as bleeding from the operation site do occur and are usually dealt with by the drain that is inserted at the end of the operation. However, in severe or rapid bleeding that can occur within the first 24 hours and which can itself compress the windpipe, an emergency re-operation may be required to control such bleeding. Fortunately, this is rare.
Wound infections can be controlled using antibiotics.
After the operation, he voice can be hoarse as a result of damage to the nerve which controls the voice box. This is usually temporary and the voice returns to normal after a few days. But rarely, this becomes a permanent problem due to irreversible damage to the nerve.
Calcium levels may fall for a few days after thyroidectomy as the parathyroid glands which control the bodies calcium levels are in close proximity to the thyroid gland and may be damaged during the operation. If this happens, you may get tingling or numbness of the hands, finger tips or lips. Calcium tablets may therefore be required for a few days. Rarely, there is permanent damage to these glands and calcium supplements are required for life.
Other rarer problems include the development of a lymphatic fistula where you may have a discharge of lymph from the neck and a thyroid storm where the body suddenly becomes over-active because of excessive thyroxine.
After a thyroid operation, regular checks on the level of thyroxine and another controller hormone called Thyroid Stimulating Hormone (TSH) are required to ensure that the correct dose of thyoxine tablets are taken.
How You Will Feel:
After surgery, there will be some pain, swelling and bruising around the wound and neck. The pain is controlled by pain killers. Drinking and eating will also cause discomfort but after around 3 days, the pain is usually reduced considerably.
During the operation, a drain is usually placed where the gland used to be to collect any blood or fluids from the operation site. This is usuallu removed after 2 days.
A hospital stay of around 4 days is normal after a thyroidectomy.
Washing of the area will be possible after 7-10 days. However, to fully recover from this procedure can take around 1 month. A feeling of lethargy and tiredness is common before then. A light job can be started after 2 weeks but a heavier or manual job can take 4-6 weeks to restart.
How Long Will you stay in Hospital after your Thyroidectomy?
Single Day In-patient Care
What to do next:
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