The thyroid is a butterfly-shaped gland in the lower front of the neck. It makes hormones that help regulate energy use, body temperature, heart function, and many other processes. This longstanding page is preserved for general education; thyroid surgery is not a current Zadeh Surgical service.
What are thyroid nodules and goiter?
A thyroid nodule is a lump within the gland. A person may have one nodule or several. Most thyroid nodules are not cancer, and many do not cause symptoms or change thyroid hormone levels. A goiter is an enlarged thyroid gland. It can result from enlarged thyroid tissue, multiple nodules, thyroid inflammation, or other causes.
Evaluation may include thyroid blood tests, an ultrasound, and a needle biopsy when the appearance or size of a nodule raises concern. An endocrinologist and a surgeon with thyroid expertise can help interpret these results together.
When may thyroid surgery be considered?
- A biopsy or other testing suggests thyroid cancer or cannot rule it out.
- A confirmed thyroid cancer requires surgical treatment.
- A nodule or enlarged gland causes pressure, trouble swallowing, breathing symptoms, or another local problem.
- An overactive nodule, large goiter, or Graves' disease is best treated surgically after comparison with medication and radioactive iodine when appropriate.
What is the difference between lobectomy and total thyroidectomy?
A thyroid lobectomy removes one half of the gland. It may be appropriate when the concerning finding is limited to one side. Some patients continue to make enough thyroid hormone with the remaining lobe, while others need thyroid hormone medicine afterward.
A total thyroidectomy removes the entire gland. It may be recommended for certain cancers, disease involving both sides, a very large goiter, or some forms of overactive thyroid disease. Lifelong thyroid hormone replacement is required after the entire gland is removed.
What risks are discussed before surgery?
Important risks include bleeding in the neck, infection, voice changes from injury or irritation of the nerves that move the vocal cords, low calcium from changes in the nearby parathyroid glands, scarring, and anesthesia-related complications. The likelihood and importance of each risk depend on the extent of surgery, the diagnosis, prior neck operations, and the surgeon's experience.
Neck swelling after thyroid surgery can be urgent.
Rapidly increasing neck swelling, trouble breathing, significant bleeding, tingling around the mouth, or cramping of the hands or feet requires prompt contact with the treating surgical team or emergency care.
What can recovery involve?
Some patients go home the day of surgery, while others stay overnight or longer. A sore throat, neck tightness, and temporary voice changes can occur. Calcium levels may be checked after a total thyroidectomy, and thyroid hormone treatment is planned according to how much of the gland was removed and the final diagnosis.
Who should evaluate a thyroid problem?
A primary care clinician or endocrinologist can begin the evaluation. When an operation is being considered, choose a surgeon who regularly performs thyroid surgery and can explain why surgery is recommended, how much of the gland should be removed, the alternatives, and the expected follow-up.