Thyroidectomy is the surgical removal of all or part of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck. It produces hormones that control every aspect of your metabolism, from your heart rate to how quickly you burn calories.
Thyroidectomy is used to treat thyroid disorders, such as cancer, noncancerous enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).
How much of your thyroid gland is removed during thyroidectomy depends on the reason for surgery. If you need only part of your thyroid removed (partial thyroidectomy), your thyroid may work normally after surgery. If your entire thyroid is removed (total thyroidectomy), you need daily treatment with thyroid hormone to replace your thyroid's natural function.
Your doctor may recommend a thyroidectomy if you have conditions such as:
Thyroidectomy is generally a safe procedure. But as with any surgery, thyroidectomy carries a risk of complications.
Potential complications include:
If you have hyperthyroidism, your doctor may prescribe medication — such as an iodine and potassium solution — to control your thyroid function and lower the bleeding risk after surgery.
You may need to avoid eating and drinking for a certain period of time before surgery, as well, to avoid anesthesia complications. Your doctor will provide specific instructions.
Before your scheduled surgery, ask a friend or loved one to help you get home after the procedure. Be sure to leave jewelry and valuables at home.
Surgeons typically perform thyroidectomy during general anesthesia, so you won't be conscious during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein. A breathing tube will then be placed in your trachea to assist breathing throughout the procedure.
The surgical team places several monitors on your body to help make sure that your heart rate, blood pressure and blood oxygen remain at safe levels throughout the procedure. These monitors include a blood pressure cuff on your arm and heart-monitor leads attached to your chest.
Once you're unconscious, the surgeon makes a cut (incision) low in the center of your neck. It can often be placed in a skin crease where it will be difficult to see after the incision heals. All or part of the thyroid gland is then removed, depending on the reason for the surgery.
If you're having thyroidectomy as a result of thyroid cancer, the surgeon may also examine and remove lymph nodes around your thyroid. Thyroidectomy usually takes one to two hours. It may take more or less time, depending on the extent of the surgery needed.
There are several approaches to thyroidectomy, including:
After surgery, you're moved to a recovery room where the health care team monitors your recovery from the surgery and anesthesia. Once you're fully conscious, you'll be moved to a hospital room.
Some people may need to have a drain placed under the incision in the neck. This drain is usually removed the morning after surgery.
After thyroidectomy, a few people may experience neck pain and a hoarse or weak voice. This doesn't necessarily mean there's permanent damage to the nerve that controls the vocal cords. These symptoms are often short-term and may be due to irritation from the breathing tube that's inserted into the windpipe during surgery, or be a result of nerve irritation caused by the surgery.
You'll be able to eat and drink as usual after surgery. Depending on the type of surgery you had, you may be able to go home the day of your procedure or your doctor may recommend that you stay overnight in the hospital.
When you go home, you can usually return to your regular activities. Wait at least 10 days to two weeks before doing anything vigorous, such as heavy lifting or strenuous sports.
It takes up to a year for the scar from surgery to fade. Your doctor may recommend using sunscreen to help minimize the scar from being noticeable.
The long-term effects of thyroidectomy depend on how much of the thyroid is removed.
If only part of your thyroid is removed, the remaining portion typically takes over the function of the entire thyroid gland. So you might not need thyroid hormone therapy.
If your entire thyroid is removed, your body can't make thyroid hormone. Without replacement, you'll develop signs and symptoms of underactive thyroid (hypothyroidism). Therefore, you'll need to take a pill every day that contains the synthetic thyroid hormone levothyroxine (Synthroid, Unithroid, others).
This hormone replacement is identical to the hormone normally made by your thyroid gland and performs all of the same functions. Your doctor will test your blood to know how much thyroid hormone replacement you need.