Your thyroid is a small gland that helps regulate your metabolism. If it develops a nodule or becomes enlarged, it can cause problems with swallowing, breathing, and hormone balance.
A lot of people don’t realize they have nodules or an enlarged thyroid until they go in for a routine checkup. Once a problem is discovered, your doctor might decide that surgery is the best option. The conditions that require thyroid surgery include:
- Thyroid cancer
- Nodules that can’t be adequately evaluated
- Goiters
- Overactive thyroid (hyperthyroidism)
Because early symptoms are often subtle, it helps to understand what to watch for. Keep reading to learn more about the thyroid, thyroid nodules, and thyroid surgery.
Understanding thyroid nodules and enlarged thyroid
The thyroid is a butterfly-shaped gland in your neck located just below the larynx and above the collarbones. It controls your heart rate and how fast you burn calories, among other metabolic functions, by releasing hormones that regulate how your body uses energy.
What are thyroid nodules?
When a cluster of abnormal thyroid tissue forms and creates a lump, this is known as a thyroid nodule . Nodules often are noncancerous and require nothing more than regular monitoring. However, some are
cancerous and require surgical thyroid removal. It’s common for people to be unaware of these nodules until they show up during routine exams or imaging.
What is an enlarged thyroid (goiter)?
An enlarged thyroid gland is known as a goiter . If it becomes big enough to push on the trachea or esophagus, a person may find it difficult to breathe or swallow.
A goiter may or may not be accompanied by nodules. It also may or may not change the functioning of the thyroid gland. Common causes of goiters include iodine deficiency, Graves’ disease, Hashimoto’s disease, and hyperthyroidism.
Why medical evaluation matters
Even though some thyroid nodules don’t cause symptoms nor lead to complications, regular monitoring is crucial for tracking changes. You don’t want to risk missing the early warning signs of potential malignancy.
A physician can perform physical exams, imaging, and biopsy testing to determine whether a nodule is benign or concerning. If a nodule becomes symptomatic, you would need an evaluation from a head and neck surgery specialist or endocrine surgeon.
Common reasons thyroid surgery is recommended
Doctors frequently suggest thyroid surgery in certain scenarios. These are typically situations when monitoring and medication aren’t enough to give you long-term relief.
Thyroid cancer
When a biopsy reveals that a nodule is cancerous, surgery often is the best recourse. The doctor will decide whether to perform a complete thyroidectomy—removal of the entire thyroid—or a partial thyroidectomy.
Nodules that can’t be adequately evaluated
It’s not uncommon for biopsy results to come back inconclusive. Doctors still may determine that there is enough of a risk of cancer to move forward with a thyroidectomy.
Goiter
A thyroidectomy surgery may be needed if a goiter grows big enough to put pressure on the airway, making it hard to breathe or swallow. When the swelling becomes visible or causes chronic throat pain, surgery may be explored as an option.
Overactive thyroid (hyperthyroidism)
When the thyroid releases too much of its hormones, that’s called hyperthyroidism . The causes include various diseases, nodules, and inflammation. Anti-thyroid medications, radioactive iodine therapy, and other treatments are available. However, a thyroidectomy might be the best alternative.
Types of thyroid surgery (thyroidectomy)
There are two main types of thyroid surgery: total thyroidectomy and partial thyroidectomy. Each one can be a minimally invasive surgery done as an outpatient procedure. Understanding each type can help you know what to expect and feel more prepared for your treatment.
Partial thyroidectomy (lobectomy)
Removing part of the thyroid, typically the right or left thyroid lobe, is known as a partial thyroidectomy , lobectomy, or hemithyroidectomy. The remainder of the gland usually can continue to function.
Total thyroidectomy
When the thyroid is removed in its entirety, it is referred to as a complete thyroidectomy. After this surgery, the patient will generally need to take synthetic hormones to mimic the function of the thyroid gland.
How do I prepare for thyroid surgery?
Your doctor will determine which surgery you need based on your medical history, the size of your thyroid, and the cause of your thyroid condition. You may undergo several lab and imaging tests to help confirm what’s causing the nodule or symptoms. A biopsy will include a fine-needle aspiration that collects a small sample of thyroid cells for evaluation.
You’ll likely have a sit-down or consultation with a head and neck surgeon to go over what to expect during the surgery. Feel free to ask any questions to make sure you fully understand the process.
Surgery preparation steps
Your doctor will give you instructions on how to prep for the day of surgery. Be sure to let them know about any medications you’re taking, as you may need to temporarily stop or adjust them. This is especially important if you’re on blood thinners because they can increase bleeding risks.
On the day of surgery, you need to fast from food and drinks for several hours before the procedure is scheduled.
What should I expect during thyroid surgery ?
Since the surgery is performed under general anesthesia, make sure to bring a trusted adult with you to drive you home. Most thyroid surgeries take 1 to 3 hours and are performed on an outpatient basis. However, you may have to stay overnight, depending on the type of surgery, whether any complications arise, or if your calcium levels need monitoring after surgery.
What is the process for a thyroid surgery ?
Here’s what to expect:
- General anesthesia with a breathing tube.
- Neck incision and thyroid removal.
- Possible lymph node sampling to check for cancer.
- Dissolvable stitches and skin glue.
- Wake up in the recovery room.
- Overnight monitoring for some patients.
- Go home once you are stable and awake.
Recovery process and post-operative care
Expect your throat to be sore from the breathing tube once you wake up from surgery. Your doctor will give you post-operative incision-care tips to help you heal faster and speed up your recovery time. If you notice any major swelling, bleeding, fever, or tingling, let your doctor know right away.
Because low calcium levels can occur after thyroid removal, your doctor may want to monitor them closely. You might receive instructions to take calcium supplements. This is especially common with people who have the whole thyroid removed. You should not resume heavy lifting or vigorous activity for at least one to two weeks.
Thyroid surgery experts in Florida
Thyroid surgery offers reliable results for thyroid-related issues when carried out by a skilled surgical team. The Endocrinology team at Florida Medical Clinic Orlando Health offers a range of treatment options for thyroid disorders. In addition, our Head and Neck Surgery Department specializes in the diagnosis and treatment of patients with disorders of the ears, nose, throat.
You can work one-on-one with experienced specialists to access advanced diagnostics for thyroid conditions. If you need a thyroidectomy, we can coordinate your care with a trusted surgeon.
About Drs. Espinola and Pfaff
Dr. Trina Espinola is a board-certified otolaryngologist and head and neck surgeon. She’s highly trained in the latest medical and surgical techniques for conditions of the ears, nose, throat, head, and neck. She has presented on topics such as thyroid cancer management and is experienced at treating thyroid and parathyroid disease. Dr. Espinola is fluent in both English and Spanish, which allows her to give all patients the utmost level of care. Request an appointment with Dr. Espinola by calling (727) 553-7100.
Dr. Julia Pfaff is a board-certified otolaryngologist and head and neck surgeon whose areas of expertise include thyroid and parathyroid disorders, head and neck cancer, and sinus conditions. Having undergone thyroid surgery during her medical training, Dr. Pfaff draws on her personal experience to connect with her patients and provide exceptional care. She is one of the few doctors in Florida qualified to perform the Inspire Implant procedure for sleep apnea. Book an appointment with Dr. Pfaff by calling (727) 553-7100.