Thyroidectomy

What is a thyroidectomy?

A thyroidectomy is a surgical procedure to remove all or part of your thyroid gland, a small butterfly-shaped gland located at the base of your neck. Your thyroid plays a crucial role in regulating your metabolism by producing hormones that control energy levels, body temperature, and heart rate.

Thyroid surgery may be recommended if you have a thyroid condition that cannot be managed with medication or other treatments.

Why might you need a thyroidectomy?

Your doctor may recommend thyroid surgery for several reasons, including:

• Thyroid cancer – To remove cancerous growths in the thyroid gland
• Large thyroid nodules – If a nodule is suspicious or causing difficulty swallowing or breathing
• Goitre (enlarged thyroid) – If the thyroid becomes too large and causes symptoms.
• Hyperthyroidism (overactive thyroid) – If medication or other treatments like radioiodine therapy are not suitable

If your doctor has advised thyroidectomy, it is usually because the benefits outweigh the risks. 

Types of thyroidectomy

There are different types of thyroidectomy depending on how much of the gland needs to be removed:

• Total thyroidectomy – The entire thyroid gland is removed. You will need lifelong thyroid hormone replacement therapy (levothyroxine)
• Partial thyroidectomy (hemithyroidectomy or lobectomy) – Only one side (lobe) of the thyroid is removed. If the remaining lobe functions normally, you may not need medication
• Subtotal thyroidectomy – Most of the thyroid is removed, but a small portion is left behind. This is less common today

Your surgeon will discuss the best option for you based on your condition.

Preparing for thyroid surgery

Before your thyroidectomy, you may need:

• Blood tests to check your thyroid function and overall health
• Imaging scans such as ultrasound or CT scans to assess the thyroid gland
• Medication adjustments if you have an overactive thyroid, to stabilise hormone levels before surgery

Your consultant will give you specific instructions, including when to stop eating and drinking before surgery.

What happens during a thyroidectomy?

A thyroidectomy is performed under general anaesthetic, meaning you will be asleep during the procedure.

·      A small incision is made at the front of your neck

·      The surgeon carefully removes part or all of the thyroid gland

·      Special care is taken to protect important structures, including the parathyroid glands (which control calcium levels) and the vocal cord nerves

·      The incision is closed with stitches or dissolvable sutures.

The procedure usually takes 1-2 hours, and most patients stay in the hospital for one night.

Risks and complications of thyroidectomy

Thyroidectomy is generally safe, but as with any surgery, there are risks:

·      Temporary or permanent voice changes – Due to irritation of the vocal cord nerves.

·      Low calcium levels (hypocalcaemia) – If the parathyroid glands are affected.

·      Bleeding or infection – Rare but possible after surgery.

·      Thyroid hormone imbalance – May require medication adjustments.

Your surgeon will discuss these risks with you before the procedure.

Recovery after thyroidectomy

Most people recover well from thyroid surgery. You may experience:

• Mild pain and swelling around the neck – this improves within a few days.
• Temporary voice changes – Your voice may be hoarse or weak, but this usually resolves.
• Low calcium levels – If the parathyroid glands are affected, you may need calcium supplements.

When can you return to normal activities?

• Most people return home the next day.
• Light activities can resume after a few days.
• You can usually go back to work in 1-2 weeks, depending on your recovery.
• Avoid heavy lifting or strenuous activity for a few weeks.

Your surgeon will provide specific aftercare advice, including wound care and follow-up appointments.

Will I need thyroid medication after surgery?

• If you have a total thyroidectomy, you will need to take levothyroxine for life to replace thyroid hormones
• If you had a partial thyroidectomy, your remaining thyroid may still function normally, and you may not need medication

Your doctor will monitor your thyroid hormone levels with regular blood tests.