Total thyroidectomy

Alternative names
Thyroid gland removal; Partial thyroidectomy; Thyroidectomy

Definition
Thyroid gland removal is surgery to remove all (total thyroidectomy) or part (subtotal or partial thyroidectomy) of the thyroid gland.

Description

Thyroidectomy is performed while the patient is under general anesthesia (unconscious and pain-free). An incision is made in the front of the neck. All or part of the thyroid gland, depending on the particular procedure, is removed.

Indications

The thyroid gland is part of the endocrine system and plays a major role in regulating the body’s metabolism. Some diseases affect the gland by reducing its output of hormones (hypothyroidism), while others cause overproduction of hormones (hyperthyroidism).

Thyroid disorders are more common in older children and adolescents (especially in girls) than in infants. Most thyroid disorders can be treated with medication, but surgery is sometimes required.

Thyroidectomy may be recommended for the following:

     
  • Increased thyroid function (hyperthyroidism or thyrotoxicosis)  
  • Decreased thyroid function (hypothyroidism) with enlargement (hypertrophy) of the gland  
  • Primary cancer of the thyroid  
  • Enlargement of the thyroid (nontoxic goiter)  
  • Patients unwilling to be treated with radioactive iodine whose hyperthyroidism cannot be treated with antithyroid drugs.  
  • Hashimoto’s disease (a type of hypothyroidism)

Risks
Risks for any anesthesia include the following:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery include the following:

     
  • Bleeding  
  • Infection

Additional risks for thyroidectomy include the following:

     
  • Bleeding and possible airway obstruction  
  • Temporary or permanent loss of ability to speak due to paralysis of the vocal chords  
  • Inadequate thyroid function (hypothyroidism)  
  • Injury to the adjacent parathyroid glands  
  • Inadequate level of calcium in the blood (hypocalcemia)

Expectations after surgery
The results of thyroid surgery are usually excellent. Monitoring of thyroid hormone production may need to continue for some months after the operation. Thyroid hormone replacement maybe necessary

Convalescence
In general, recovery from thyroid surgery is very rapid, and you should be able to resume all normal activities, including going back to school or work, within a few weeks.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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