When certain conditions interfere with normal thyroid production, surgical removal of the thyroid gland is performed. This is usually done when thyroid cancer has been detected, an otherwise benign thyroid nodule grows so large it causes problems or hyperthyroidism (a disorder in which excess thyroid hormone is produced) does not respond to treatment with medications or radioactive iodine, though this is rare.
Thyroid surgery is known as a thyroidectomy. Two types of procedures are performed: a total thyroidectomy to remove the entire gland or a subtotal thyroidectomy, which removes part of the gland.
In a total thyroidectomy, the entire gland and surrounding lymph nodes are removed. The patient is given drugs to suppress thyroid hormone production, in addition to radioactive iodine. A subtotal thyroidectomy involves removal of one complete gland and part of the other, which is usually reserved for treating hyperthyroidism caused by Grave’s disease.
The effectiveness of any surgical thyroid procedure depends on the type of cancer present and how much it has spread. Overall, the surgery is considered safe, but may lead to complications that include injury to the vocal cords and larynx (which could cause hoarseness, changes in the voice and problems speaking or swallowing).
Like the thyroid, the parathyroid is a group of neck glands (four total) that produces hormones essential to regulating the body’s functions – in this case, the amount of calcium in the blood. When the glands produce an overabundance of parathyroid hormone, the result is too much calcium, a condition known as hyperparathyroidism. This is often caused by an adenoma, a type of benign tumor. Minor cases may be dealt with medically, but parathyroid surgery is often recommended.
Whether to proceed with parathyroid surgery depends on a number of factors including the you age, how much calcium is in the blood and the extent of symptoms. There are several different procedures for surgical removal of the parathyroid glands. The approach utilized depends on which glands are affected. You will receive a general anesthetic, and the surgeon makes an incision in the neck to examine the glands and determine which ones require removal.
In a minimally invasive parathyroidectomy, the diseased glands are removed through a small slit in the neck. A video-assisted parathyroidectomy utilizes two small cuts – one for surgical instruments, the other for a tiny camera that helps the surgeon view the area. An endoscopic parathyroidectomy is similar, but involves two or three incisions in the front of the neck and another above the breastbone to minimize scarring and speed up recovery time.
A follow-up visit is necessary to ensure calcium levels are under control. In some cases, additional surgeries may be needed.
All surgeries involve some degree of risk, such as bleeding, infection and reactions to anesthesia. Parathyroid surgery could cause injury to the thyroid gland and vocal cords or cause breathing problems. In addition, you could be at risk for hypocalcemia, a condition in which calcium levels drop too low. Fortunately, this is easily treatable. For our other throat services, click here!
Call Sanjay Athavale, MD at (770) 217-6224 for more information or to schedule an appointment.