A thyroidectomy is surgery to remove all or part of the thyroid gland. If a person has the entire gland removed, they will need to take tablets to replace the thyroid hormone for the rest of their life.
Why is a thyroidectomy performed?
The thyroid is a butterfly-shaped gland in a person’s neck, just below the Adam’s apple. It produces the hormone thyroxine which controls the body’s metabolism (for example, weight, heart rate, temperature and growth).
Someone might need part or all of their thyroid gland removed if:
- they have thyroid cancer
- they have an enlarged thyroid (goitre) that makes it difficult to swallow or breathe
- they have an overactive thyroid (hyperthyroidism)
The removal of part of the thyroid gland is called a partial thyroidectomy or hemithyroidectomy and the removal of the entire gland is called a total thyroidectomy.
If someone has a total thyroidectomy, they will need to take thyroxine tablets for the rest of their life. Some people also need to take thyroxine tablets after a partial thyroidectomy. It depends on how much of the thyroid gland is removed.
How to prepare for the procedure
If you need to have a thyroidectomy, your surgeon will first order scans such as an ultrasound or CT scan. If you have a growth on your thyroid, your doctor may take a small sample with a fine needle to diagnose what it is. This is known as a biopsy. They will also work out the positioning of the vocal cords before the surgery, since these are very close to the thyroid gland.
Thyroidectomies are usually performed under general anaesthetic. You will be asked not to eat or take medicines the day before, although you should talk to your doctor before you stop taking any medicines.
If you have hyperthyroidism, however, your doctor may ask you to eat a special diet or take medicine before the surgery to help the thyroid to function better and reduce the risk of bleeding.
What happens during the procedure?
The surgeon will make a cut in the front of the neck, 2cm to 3cm above the collar bone. They will divide the muscles so they can reach the thyroid gland.
They will be very careful not to damage the vocal cords or the parathyroid glands that sit behind the thyroid. These glands control the body’s calcium levels.
The surgeon removes the thyroid gland. The muscles are then put together and the wound is stitched to close it up.
What to expect after the procedure
After the operation is finished, the pulse, blood pressure and other vital signs will be monitored for a while. There may be a tube in the neck to drain fluid. This will probably be removed the next day.
You may be drowsy after the anaesthetic and take a few days to recover. Your voice may be hoarse or weak and you may have some pain in your neck. These symptoms normally go away quickly.
You will probably be able to go home the same day or the next day. However, don’t do anything strenuous for 10 days after the surgery.
What can go wrong
A thyroidectomy is a safe operation. But, like any surgery, there may be risks involved, including:
- reactions to the anaesthetic
- chest infection
- blood clots
- heart and circulation problems
- infection of the wound
Some people develop a blood clot in their windpipe which needs to be removed with another operation.
Damage to the vocal cords is rare and is normally temporary, but in up to 1 in 50 cases the voice may be permanently hoarse. In this case, someone will need speech therapy or more surgery. If you are a singer, your performing voice may permanently change.
If there is any damage to the parathyroid glands you may have low calcium levels in your blood which may need to be treated with calcium and vitamin D tablets.
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Last reviewed: April 2020