Thyroid Surgery - What Are The Types Of It?

Thyroid is a butterfly-shaped gland present in the lower neck on either side of the trachea (breathing tube). It produces hormones (thyroxin) which regulate metabolism. However, excessive hormone production by the thyroid gland results in excessive appetite, loss of weight, palpitations, fast heart rate and prominent eyeballs. In adolescence, there is a possibility of the prominence of the thyroid (physiological goitre). Thyroid may get enlarged, have modularity which is called goitre. Goitre is common in geographical areas of iodine deficiency.

Thyroid cancer may develop in children and adults. Sometimes cancer may be very small and not felt by the examining fingers, but there are multiple lymph nodes swellings in the neck due to the spread of cancer. These cancers have a relatively good prognosis.

Thyroid Surgery :

Thyroid surgery is undertaken under general anesthesia for all the above conditions and part or whole of the diseased gland is surgically removed. If one-half of the thyroid is removed it is called Thyroid Lobectomy. If the entire thyroid gland is removed it is called Total Thyroidectomy. If part of the thyroid is removed it is called Partial Thyroidectomy.

Thyroid surgery must be undertaken by a specialist surgeon in view of the close proximity of two important structures parathyroid glands and recurrent laryngeal nerves, which must be protected during surgery.

Why do you need surgery?

1. The presence of tumors or nodules in the thyroid. Although most of the nodules are benign, few can be malignant. Benign nodules may increase in size and can cause pressure symptoms on the air passage. They can be problematic as well if they cause the thyroid gland to overproduce hormones, resulting in hyperthyroidism.

2. Primary hyperthyroidism can be corrected through surgery. It is often an outcome of Grave’s disease, an autoimmune disorder wherein the body misidentifies the thyroid gland as a foreign body, thereby creating antibodies to combat it. The thyroid gland gets inflamed in the process, resulting in the overproduction of hormones.

3. Enlargement of thyroid gland, (Non-inflammatory non-neoplastic enlargement of thyroid), termed as goitre. A large nodular goitre can cause pressure on the trachea leading to difficulty in breathing.

Types of Surgery -

1. Lobectomy is the removal of one of the lobes when a nodule or tumour affects one lobe of the thyroid gland.

2. Subtotal Thyroidectomy: Here, a small proportion of the thyroid tissue is left behind even after the removal of the thyroid gland.

3. Total Thyroidectomy: Both lobes of the thyroid gland are removed, mainly for cancer. It should be undertaken by specialist thyroid surgeon since it carries the risk of damaging recurrent laryngeal nerve resulting in changing in voice and risk of removing all parathyroid glands / or damaging their blood supply which results in tetany in immediate prospective period and osteoporosis in long run.