Thyroidectomy

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A thyroidectomy involves the surgical removal all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism).

The thyroid produces several hormones, such as thyroxine (T4), triiodothyronine (T3) and calcitonin.

After the removal of a thyroid patients usually take prescribed oral synthetic thyroid hormones to prevent the most serious manifestations of the resultant hypothyroidism.

Less extreme variants of thyroidectomy include:

  • "hemithyroidectomy" (or "unilateral lobectomy") -- removing only half of the thyroid
  • "isthmectomy" -- removing the band of tissue (or isthmus) connecting the two lobes of the thyroid

A "thyroidectomy" should not be confused with a "thyroidotomy" ("thyrotomy"), which is a cutting into (-otomy) the thyroid, not a removal (-ectomy) of it. A thyroidotomy can be performed to get access for a median laryngotomy, or to perform a biopsy. (Although technically a biopsy involves removing some tissue, because the volume removed is minuscule, it is more frequently categorized as an -otomy than an -ectomy.)

[edit] Complications

1. Hypothyroidism in up to 50% of patients after ten years

2. Laryngeal nerve damage in about 1% of patients, in particular the recurrent laryngeal nerve: Unilateral damage results in a hoarse voice. Bilateral damage presents as laryngeal obstruction on removal of the tracheal tube and is a sugical emergency: an emergency tracheostomy must be performed

3. Hypoparathyroidism in about 1% of patients

4. Haemorrhage

5. Thyrotoxic crisis

6. Recurrent Laryngeal nerve damage may occur involving the ligature of the inferior thyroid artery. This may cause complete absence of voice.

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