Definition

Thyroid = a butterfly-shaped endocrine gland in the neck that is found on both sides of the trachea (windpipe). It secretes the hormone thyroxine, which controls the rate of metabolism.

-ectomy = removal of

Partial = not total or entire

This procedure involves removal of all or part of the thyroid gland. The thyroid gland produces hormones that help regulate your metabolism. This gland is located in the front of the neck below the voice box.

Purpose of Procedure

There are two reasons why this procedure is done: to remove a nodule to check for malignancy, and to remove the majority of the gland due to over activity.

Preparation

As with any procedure using anesthesia, you will be asked not to eat or drink anything after midnight on the evening prior to your surgery . You may brush your teeth in the morning but not swallow the water. If you are on medications that must be taken, you will have discussed this with us and/or the anesthesiologist and instructions will have been given to you.

The procedure will not be performed if you are currently taking, or have recently taken any medication that may interfere with your ability to clot your blood (“blood thinners, aspirin, anti inflammatory medicines, etc … “). Please refer to the attached list and tell us if you took any of these within the past 10 days. If your medication is not on the list, alert us immediately so that we may ensure optimal procedure safety. We will have reviewed all of your medications with you during the pre-operative / pre-procedure consultation. You are obligated to inform us if anything has changed (medication or otherwise) since your previous visit. .

Procedure

This procedure involves making an incision in the front of the neck below the thyroid gland. The incision is made along the natural skin lines to reduce the appearance of a scar. The incision is extended down through soft tissue in the neck to expose muscles that lie over the thyroid gland. These muscles are then retracted. Blood vessels to the thyroid gland are identified and cut. Other glands found on each side of the thyroid gland, called the parathyroid glands, are identified and protected. Nerves that travel under the thyroid gland and move the vocal cords are also identified and protected. The abnormal portions of the thyroid gland are then removed. Bleeding is controlled with suture material or electrocautery. In some instances, this surgery is performed for cancer, and the surrounding lymph nodes in that area may be check for any spread of the cancer. A drain is placed in the surgical site. The wound is closed in layers using absorbable and removable suture material. A surgical dressing will be applied.

Post Procedure

You will be in the recovery room before being transferred to a regular hospital room. Pain medication will be prescribed to manage discomfort. Dressings will be changed daily until drainage is minimal and then the drain is removed. Discharge from the hospital will then be arranged. A follow-up appointment for suture removal will be scheduled. Water exposure on the site of the incision should be avoided until the sutures have been removed. Pain medication may be needed for up to 2 weeks. Post-operative pain medications may include a codeine type medication that may cause drowsiness. Operation of motor vehicles or machinery is not allowed while using this medication. Returning to work or school can occur as soon as pain medication is no longer needed during the day.

Expectations of Outcome

This procedure should result in removal of the abnormal tissue and restoration of a more normal thyroid function.

Possible Complications of the Procedure

This is a safe procedure, however, there are uncommon risks that may be associated with it. While we have discussed these and possibly others in your consultation, we would like you to have a list so that you may ask questions if you are still concerned. It is important that every patient be made aware of possible outcomes that may include, but are not limited to:

  • Anesthesia complications: There is always a small risk with general anesthesia. This risk is increased if there is any family history of trouble with anesthesia. The risks can range from nausea and vomiting to very rare life threatening problems. You can discuss any questions with your anesthesiologist.
  • Bleeding
  • Infection
  • Scarring
  • Injury to the nerves that move the vocal cords, resulting in hoarseness or impaired speech
  • An under active parathyroid with a lifelong need to supplemental calcium
  • Lifelong need for thyroid medication
  • Airway obstruction, although rare

We provide this information for patients and family members. It is intended to be an educational supplement that highlights some of the important points of what we have previously discussed in the office. Alternative treatments, the purpose of the procedure/surgery, and the points in this handout have been covered in our face-to-face consultation(s). For more informatin, please contact The Ear, Nose and Throat Clinic.