Thyroid and endocrine surgery
Thyroid surgery treats nodules, goitres and thyroid cancers. Most thyroid nodules are benign and many need monitoring rather than removal. Assessment combines examination, blood tests, ultrasound and, where indicated, a needle biopsy.
Thyroid nodules
Thyroid nodules are common and are frequently found incidentally on scans performed for other reasons. The great majority are benign.
Assessment establishes whether the nodule is producing excess hormone, whether it has features on ultrasound that warrant sampling, and whether it is causing pressure symptoms such as difficulty swallowing or a sensation of tightness.
When surgery is considered
Surgery may be recommended when a biopsy shows or suspects cancer, when a nodule or goitre is large enough to cause pressure symptoms, when a nodule is overproducing thyroid hormone and other treatments are unsuitable, or when a diagnosis cannot be established any other way.
The operation may remove half the thyroid or all of it, depending on the diagnosis and the extent of the problem.
What the operation involves
Thyroid surgery is performed through an incision at the front of the neck, positioned to sit within a natural skin crease where possible.
Two structures require particular care: the nerves supplying the voice box, and the parathyroid glands, which control calcium. Protecting both is central to the operation, and your surgeon should discuss the associated risks with you directly before you consent.
If the whole thyroid is removed, lifelong thyroid hormone replacement is required. This is taken as a single daily tablet.
Common questions
Are most thyroid nodules cancerous?
No. The great majority of thyroid nodules are benign. Ultrasound features and, where indicated, a needle biopsy are used to identify the small proportion that need further treatment.
Will I need to take medication after thyroid surgery?
If the entire thyroid is removed, lifelong thyroid hormone replacement is required, taken as one daily tablet. If only part is removed, the remaining thyroid often produces enough hormone on its own, though this is monitored.
Will thyroid surgery affect my voice?
The nerves supplying the voice box run close to the thyroid and protecting them is a central part of the operation. Voice change is a recognised risk that your surgeon should discuss with you specifically before you consent.
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