Removal of the thyroid gland may be recommended for a variety of reasons. Most often this is because there is a suspicion of a tumor in the thyroid or that the thyroid has grown to a very large size – sometimes called a “goiter” -- and is causing other problems with breathing or swallowing.
In thyroid surgery, an incision is made in the low midline neck, and the thyroid gland is isolated. The surgery is designed to remove the thyroid gland without injury to structures and other glands that are nearby.
The parathyroid glands are tiny glands located on the back surface of the thyroid gland. These glands are responsible for regulation of calcium in your body.
There are four small glands, although only one is required to have good calcium balance. During the procedure, identification of the parathyroid glands is one of the important technical aspects that is performed by your surgeon in removal of the thyroid gland. Additionally, the recurrent laryngeal nerve, which is a nerve that operates the voice box, runs directly behind the thyroid gland.
Thyroid surgery is performed and designed to minimize any injury to the recurrent laryngeal nerve. If the recurrent laryngeal nerve is injured, it will result in a breathy, hoarse voice. In some cases, there may be just a stretch injury to the nerve, which will improve with time. In other cases, if the nerve is affected by tumor, or inadvertently injured during the surgery, the voice can remain somewhat breathy. If this occurs, additional procedures can be performed to improve your voice.
The risk of injury to the recurrent laryngeal nerve is very small with an experienced surgeon. Once the thyroid gland is excised, the incision is closed, and a small drain is placed within the area where the thyroid gland once existed. This is left there to assist with drainage of lymph fluid from the area.
In general, this stays in for approximately 24 hours, and is then removed by your doctor prior to your discharge from the hospital. Additionally, your calcium levels will be monitored during the postoperative period to assure that they are stable.
Post-operative Instructions
After your thyroid surgery and discharge from the hospital, you will be asked to apply antibiotic ointment to the incision line twice daily. Additionally, some hydrogen peroxide can be used to clean any crusting that occurs on the incision.
You will return in one week postoperatively for suture removal, and after the sutures are removed, you can use vitamin E oil or Mederma, which can be bought over the counter at your local pharmacy, to minimize the appearance of the scar.
Additionally, we recommend that you keep sunscreen on this area for approximately one year to minimize scarring as well. Depending on the specific reason for your thyroidectomy, additional treatment may be necessary. If so, this will be discussed with you in person and in detail.
