What is the thyroid?
The thyroid is a small, butterfly-shaped gland located at the lower front portion of your neck just beneath Adam’s apple. It consists of two lobes and is part of a convoluted network of glands called the endocrine system, responsible for regulating various body functions. The thyroid gland generates hormones that regulate the body’s metabolic rate as well as heart rate, digestive function, muscle control, bone metabolism, and brain development. Its adequate development and functioning depend on maintaining a good supply of iodine from the daily dietary routine.
A thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland, generally performed by an endocrine or head and neck surgeon. There are several variants of thyroidectomy. The most common being lobectomy/hemithyroidectomy (removal of one lobe of gland), subtotal thyroidectomy (removal of whole gland except some part), and total thyroidectomy (complete removal of gland). The least common kinds include partial lobectomy, near-total thyroidectomy, isthmusectomy, and Hartley Dunhill surgery.
A complete blood profile, thyroid function tests, and a thyroid scan is essential before the patient is admitted for the operation. The procedure is 2-4 hours long and is done under general anesthesia.
Indications of thyroidectomy
There are certain indications for the removal of thyroid gland. Some of them include:
- Toxic multinodular goiter
- Toxic solitary nodule
- Malignant goiter
- As a therapy for patients with thyrotoxicosis
- Substernal extension
- Follicular neoplasia
- Pressure symptoms
Thyroidectomy is a complicated procedure and post-op care is as much important as the surgical procedure itself. Care of the wound and surgical drains are done by hospital staff and the usual stay is around 7-10 days.
How to take care of the surgical incision?
Gently wash the incision with lukewarm water and pat dry it.Avoid using vitamin E based ointments or moisturizers before the first follow up.
How to get rid of the surgical scar?
Neck incisions heal rapidly, usually within a week or two.Your scar will be most visible for the first 1-3 months following surgery, improve considerably over 2-5 months, and gradually fade over the next 6-9 months.Experts at John Hopkins recommend the application of SPF 30 sunscreen over the scar for at least a year.Various chemical peels, laser scars removal procedure, and dermabrasion may also be prescribed by some surgeons to get rid of the scar.
The patients should be invigorated to have liquids and soft food i.e. mashed potatoes, apple sauce, jello, pudding, and yogurt. A strict low iodine diet is sustained.
Several complications can arise from:
- Wound infection
- Airway obstruction
- Thyroid storm
- Recurrent laryngeal nerve damage
- Hoarseness of voice