A thyroidectomy is the removal of the whole (total) or part (lobectomy) of the thyroid. Critical is the protection of the recurrent laryngeal nerves (voice) and the parathyroid glands (calcium). The extent depends on the diagnosis.
What is a thyroidectomy?
It is the surgical removal of the thyroid gland, whole or one lobe. The operation requires meticulous technique to protect the neighbouring structures.
When is it needed?
It is indicated for cancer or suspicious nodules of the thyroid, a large goitre with compressive symptoms, and selected cases of hyperthyroidism not controlled with medication.
Preparation
An endocrine assessment, ultrasound and cytology (FNA) of nodules are done, along with a vocal-cord check. Thyroid function is optimised before surgery where needed.
How it's done
Through a small incision at the base of the neck, the thyroid (or lobe) is removed with careful identification and protection of the recurrent laryngeal nerves and parathyroids. Where oncologically indicated, a lymph-node dissection is added.
Lobectomy
Removal of one lobe for unilateral disease — often preserves thyroid function.
Total thyroidectomy
Removal of the whole gland for malignancy, large goitre or hyperthyroidism — requires replacement.
Nerve monitoring
Intraoperative nerve monitoring & careful parathyroid preservation to protect voice/calcium.
Recovery
Discharge is usually the next day. After a total thyroidectomy, thyroxine replacement is given and calcium is monitored. Return to activities is rapid.
Risks & outcomes
In specialist hands complications are rare. They include transient voice hoarseness, transient or rarely permanent hypoparathyroidism (low calcium), haematoma or infection.
Frequently asked questions
Will my voice change?
The aim is to protect the nerves of the voice by carefully identifying them. Temporary change can rarely occur; permanent injury is very rare in specialist hands.
Will I need medication afterwards?
After a total thyroidectomy, daily thyroxine replacement is needed. After a lobectomy, the remaining gland often covers the needs.
What about calcium?
The parathyroid glands, which regulate calcium, are carefully preserved. Calcium is monitored after surgery and, if needed, temporary supplementation is given.
Will there be a visible scar?
The incision is placed in a natural skin crease at the base of the neck and usually fades with time.