Thyroid surgery is a procedure that involves removing part of all of your thyroid gland. The thyroid gland consists of two lobes and if only a part (or a lobe) of the thyroid is removed, this called a hemithyroidectomy. If both lobes of the gland are removed, this is called a total thyroidectomy.
Before having thyroid surgery, it is important to discuss with your doctor the risks, benefits, and alternatives to proceeding with surgery. Depending on the reason for your thyroid surgery you may require blood work and laboratory testing, in addition to imaging, in preparation for your surgery. Sometimes you may need a biopsy of the thyroid gland to help in deciding the type of surgery you need.
Thyroid surgery is performed for one of two reasons. The first is the presence of thyroid cancer. If your surgeon has detected cancer cells in your thyroid gland you may need part or all of your thyroid gland removed through surgery. Depending on the stage, size, and extent of cancer, you and your surgeon can come up with a specially tailored plan to fit your needs. The second reason is the presence of a thyroid nodule that is suspicious for cancer. These are nodules that have a high probability of being cancer, and therefore need to be removed for closer evaluation. This surgery usually only involves removing the part of the thyroid with the suspicious nodule and not the whole thing.
Thyroid surgery is one of the most commonly performed surgeries today. It is usually performed under general anesthesia in a hospital or an ambulatory care facility. Depending on the type of surgery, you may be able to go home the same day or may require a short hospital stay for observation. The actual surgery involves making a small incision in the front part of your neck below the Adam’s apple. Surgeons try and hide the scar as best they can so that it heals in the most imperceptible way possible. Once the surgery is complete, you are awoken and after a short recovery period, you may go home.
Depending on the type of surgery, you may be able to go home right after the surgery. Sometimes, you may need to stay in the hospital for a short stay (24 hours) for observation before you can be released to go home. It is not uncommon to have some difficulty and soreness with swallowing. This typically resolves after a few days, but sometimes may last up to 2 weeks. It is also not too uncommon to experience some hoarseness that usually resolves after several days. You may experience pain and discomfort in the neck from having the surgery, and pain medicines are usually prescribed to manage this pain. Depending on the surgery, the surgeon may also leave some drains in the neck to assist with healing and to prevent complications. These are usually removed before you leave the hospital or at your first office visit. If all of the thyroid glands are removed, your physician will likely prescribe a replacement medicine that you will begin the day after surgery, and will be on indefinitely. Other medications may include calcium supplementation pills that are temporary, in addition to antibiotics.
We usually recommend no heavy lifting or exercising during the healing period, while recommending staying home from work until your first postoperative office visit. This is to maximize your healing and prevent any complications. During this time period, your surgeon will specify how best to manage your neck incision site. Some surgeons recommend no bathing or showering for 24 hours, while other surgeons may apply a waterproof dressing. It is important to clarify the specific instructions with your doctors and nurses. Depending on how you are healing, your surgeon will clear you to resume regular activities.
Thyroid surgery is typically covered by your insurance. Depending on the type of insurance you carry, there may be associated out of pocket expenses. Fortunately, Dr. Mourad’s staff are experts in understanding insurance, and work closely with insurance companies, making sure to maximize your benefits.
As with all surgical procedures, there are potential risks. Fortunately, thyroid surgeries are some of the most commonly performed surgeries in the United States today. However, it is important to be informed about potential complications by your surgeon. The most common risk is the risk of nerve injury. The voice box is controlled by nerves that are very close to the thyroid gland. Removing the gland may result in stretching or injury of the nerve that results in temporary or permanent hoarseness postoperatively. Other times, the nerve may need to be removed intentionally to remove all thyroid disease causing permanent voice changes. Surgeons often use nerve monitoring devices that give real-time feedback and assist in determining the integrity of the nerve.
Other complications include a drop in your blood calcium levels. The part of your body that controls calcium regulation is very closely involved with the thyroid gland. Removing the thyroid gland may cause a temporary or permanent drop in your calcium that requires oral calcium supplementation. Sometimes, in the most severe cases, this may require hospitalization for IV supplementation.
Fortunately, risks during thyroid surgery are low, but present. It is important to fully understand these risks before undergoing the procedure.
Thyroid surgery may involve other procedures depending on the indication for your surgery. If you are undergoing thyroid surgery for cancer removal, your surgeon may also address other parts of your neck, to remove all disease. The surgeon may perform what is called a neck dissection that involves removing neck lymph nodes that may have the disease. Patients that also have a history of thyroid cancer may also need to have Radioactive Iodine Ablation (RAI) after surgery. This involves administering radiation therapy to remove any residual cancer cells in the body.
Depending on the type of surgery you have, you may be able to go home the same day or may require a short term stay (24 hours) in the hospital. If you only had part of your thyroid gland removed, you may likely be able to go home that same day. Sometimes, if the whole gland has been removed, you may need to spend the day in the hospital to monitor for any complications.
Yes. Thyroid surgery is one of the most commonly performed surgeries in the United States. In 2014, approximately 60,000 new cases of thyroid cancer were diagnosed, and this number is expected to nearly double by 2025.
Thyroid surgery involves removing and manipulating the thyroid gland that sits very close to the voice box and the nerves that control your voice. Most often, there is no impact on your voice. However, depending on the size and location of the thyroid gland and thyroid disease, the nerves may be stretched, injured, or even purposefully removed that may cause a temporary or permanent weakening and change in your voice quality. If you are a professional voice singer, that requires a wide range in your vocal quality, this also may be impacted by thyroid surgery. Surgeons often use intraoperative nerve monitoring techniques to help protect and identify the nerves of the voice box, minimizing any potential impact on your voice.
Dr. Mourad is an expert in the area of thyroid surgery and is one of New York City’s highest volume thyroid surgeons. He routinely performs more than 50 thyroid surgeries every year, in addition to having published leading scientific works on thyroid surgery and thyroid cancer. He is also a leading expert in the field, pioneering new research harvesting the power of artificial intelligence to help manage patients with thyroid cancer. His research was recently presented at the International Federation of Head and Neck Surgery (IFHNOS) 6th World Congress in Argentina.