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.
Why it’s done
A thyroidectomy may be recommended for conditions such as:
- Thyroid cancer. Cancer is the most common reason for thyroidectomy. If you have thyroid cancer, removing most, if not all, of your thyroid is likely to be an option for treatment
- Noncancerous enlargement of the thyroid (goitre). Removing all or part of your thyroid gland is an option if you have a large goitre that is uncomfortable or causes difficulty breathing or swallowing or, in some cases, if the goitre is causing hyperthyroidism
- Overactive thyroid (hyperthyroidism). Hyperthyroidism is a condition in which your thyroid gland produces too much of the hormone thyroxine. If you have problems with anti-thyroid drugs and don’t want radioactive iodine therapy, thyroidectomy may be an option
Surgeons perform thyroidectomy during general anaesthesia, so you won’t be conscious during the procedure. The surgeon makes a small incision in the centre of your neck or a series of incisions some distance from the thyroid, depending on the surgical technique used. 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.
There are three main approaches to thyroidectomy:
- Conventional thyroidectomyinvolves making an incision in the centre of your neck to directly access your thyroid gland
- Endoscopic thyroidectomyuses smaller incisions in the neck. Surgical instruments and a small video camera are inserted through the incisions. The camera guides your surgeon through the procedure
- Robotic thyroidectomyis performed either through incisions in the chest and armpit or via an incision high in the neck. The robotic approach allows a thyroidectomy to be performed while avoiding an incision in the centre of your neck
After surgery, 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 10 days or so. 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 without replacement 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 synthetic thyroid hormone levothyroxine. 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.