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Writer's pictureDr. Preethi MS., DNB., (ENT)

Understanding Thyroidectomy: What you need to know

Thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. The thyroid gland is a butterfly-shaped endocrine gland located in the neck that produces hormones that regulate the body's metabolism. These hormones control the body's heart rate, blood pressure, body temperature, and weight.


Indications for thyroidectomy:

  1. Benign nodules: Large or growing benign nodules in the thyroid gland can cause symptoms such as difficulty swallowing or breathing, and may be removed surgically.

  2. Goiter: A thyroidectomy may be performed to remove a goiter, which is an enlarged thyroid gland that can cause a visible lump in the neck.

  3. Thyroiditis: Thyroiditis is a condition in which the thyroid gland becomes inflamed and a thyroidectomy may be recommended for patients with this condition.

  4. Thyroid cancer: A thyroidectomy is often recommended as the first line of treatment for thyroid cancer, which is the removal of the entire thyroid gland or part of it.

  5. Family history of thyroid cancer: In some cases, a thyroidectomy may be recommended for individuals with a family history of thyroid cancer, even if they do not have any symptoms or signs of the disease.

  6. Hyperthyroidism: A thyroidectomy may be recommended for patients with hyperthyroidism (overactive thyroid) who do not respond to other treatments, such as medication or radioactive iodine.

It is important to note that not all thyroid conditions require surgery and a thyroidectomy should only be done when it is the most appropriate treatment option after careful consideration and consultation with the ENT surgeon.



Types of thyroidectomy:

  1. Total Thyroidectomy: A total thyroidectomy involves the removal of the entire thyroid gland. This procedure is typically recommended for patients with thyroid cancer or large benign nodules that are causing symptoms.

  2. Near-total Thyroidectomy: A near-total thyroidectomy involves the removal of most of the thyroid gland, leaving behind a small amount of thyroid tissue on one side.

  3. Subtotal or partial Thyroidectomy: A subtotal or partial thyroidectomy involves the partial removal of both lobes of the thyroid gland. This procedure is typically recommended for patients with benign nodules or small thyroid cancers that are confined to one lobe of the gland.

  4. Hemithyroidectomy: A Hemithyroidectomy is the surgical removal of one half of the thyroid gland along with the isthmus (the part of thyroid gland that connects both the lobes in the middle).

  5. Lobectomy: A lobectomy is a surgical procedure that involves the removal of one lobe of the thyroid gland. This procedure is typically recommended for patients with benign nodules.

It's important to note that the type of thyroidectomy that is performed will depend on the specific condition being treated, the patient's overall health


Preparation for a thyroidectomy typically involves a few key steps, including:

  1. Consultation with your surgeon: Your surgeon will explain the procedure, the risks and benefits, and answer any questions you may have. They may also perform a physical examination and order laboratory tests to ensure you are healthy enough for the surgery.

  2. Pre-operative instructions: Your surgeon will give you specific instructions on how to prepare for the surgery, such as fasting for a certain period of time before the procedure, stopping certain medications, and showering with an antiseptic solution.

  3. Pre-operative testing: You may need to undergo tests such as a chest x-ray or an electrocardiogram (ECG) to ensure that your heart is healthy enough for the surgery.

  4. Medications: Your surgeon will advise you on what medications you can and cannot take before the surgery.

  5. Follow the instruction as given by your surgeon: Follow all the instructions that your surgeon gives you before and after the surgery.

  6. Inform the surgeon about any medical condition you have.

It is important to follow these instructions carefully to ensure the best possible outcome.


The surgery is done under general anaesthesia and usually takes 2 to 4 hours.


Risks of thyroidectomy

  • Bleeding: As with any surgery, there is a risk of bleeding.

  • Damage to nearby structures: The surgery can cause damage to nearby structures, such as the parathyroid glands, which regulate calcium levels in the body, or the recurrent laryngeal nerve, which controls the muscles of the larynx (voice box).

  • Hypothyroidism: After a total thyroidectomy, the patient will develop hypothyroidism, which will require lifelong hormone replacement therapy.

  • Infection: As with any surgery, there is a risk of infection.

  • Scarring: There will be a scar on the neck after the surgery.

  • Anesthesia risk: As with any surgery requiring general anesthesia, there are risks associated with the anesthesia itself.


It is important to discuss the risks and benefits with your surgeon and closely follow the instructions provided before and after the surgery to minimize risks and maximize benefits. It is also important to follow the post-surgery instructions given by your doctor and to keep in touch with them for follow-up visits. Remember to have a support system in place, as you will need help and care after the surgery. With the right preparation and care, recovery from thyroidectomy surgery can be smooth.

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