Thyroidectomy is the removal of all or part of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck. It produces hormones that regulate every aspect of your metabolism, from your heart rate to how quickly you burn calories.
Thyroidectomy is used to treat thyroid disorders, such as cancer, noncancerous enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).
How much of your thyroid gland is removed during thyroidectomy depends on the reason for surgery. If only a portion is removed (partial thyroidectomy), your thyroid may be able to function normally after surgery. If your entire thyroid is removed (total thyroidectomy), you need daily treatment with thyroid hormone to replace your thyroid’s natural function.
A thyroidectomy may be recommended for conditions such as:
If you have hyperthyroidism, your doctor may prescribe medication — such as an iodine and potassium solution — to regulate your thyroid function and decrease the risk of bleeding.
You may need to avoid eating and drinking for a certain period of time before surgery, as well, to avoid anesthesia complications. Your doctor will provide specific instructions.
Surgeons perform thyroidectomy using general anesthesia, so you’re unconscious during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein.
The surgical team places several monitors on your body to help make sure that your heart rate, blood pressure and blood oxygen remain at safe levels throughout the procedure. These monitors include a blood pressure cuff on your arm and heart-monitor leads attached to your chest.
Once you’re unconscious, the surgeon makes a small incision in the front of your neck or a series of incisions under your arm, depending on the surgical technique he or she uses. All or part of the thyroid gland is then removed, depending on the reason for the surgery. If you’re having thyroidectomy as a result of thyroid cancer, the surgeon may also examine and remove lymph nodes around your thyroid. Thyroidectomy usually takes several hours.
Three main approaches to thyroidectomy exist:
After surgery, you’re moved to a recovery room where the health care team monitors your recovery from the surgery and anesthesia. Once you’re fully conscious, you’ll be moved to a hospital room. You may have a drain under the incision in your neck. This drain is usually removed the morning after surgery. After a thyroidectomy, you may experience neck pain and a hoarse or weak voice. This doesn’t necessarily mean there’s permanent damage to the nerve that controls your vocal cords. These symptoms are often temporary and may be due to irritation from the breathing tube (endotracheal tube) that’s inserted into your windpipe (trachea) during surgery, or as a result of nerve irritation caused by the surgery.
You’ll be able to eat and drink as usual after surgery. Most people who have thyroidectomies remain in the hospital for about 24 hours. When you go home, you can usually return to your regular activities, often within a few weeks. Talk to your doctor about specific activity restrictions.
The long-term effects of thyroidectomy depend on how much of the thyroid is removed.
If only part of your thyroid is removed, the remaining portion typically takes over the function of the entire thyroid gland, and you don’t need thyroid hormone therapy.
If your entire thyroid is removed, your body can’t make thyroid hormone and you’ll develop signs and symptoms of underactive thyroid (hypothyroidism). As a result, you’ll need to take a pill every day that contains the thyroid hormone thyroxine (Levothroid, Levoxyl, others). This hormone replacement is identical to the hormone normally made by your thyroid gland and performs all of the same functions. Your doctor will determine the amount of thyroid hormone replacement you need based on blood tests.
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