Thyroidectomy
Removal of the Thyroid Gland

Thyroidectomy is an operation to remove part or all of the thyroid gland.

Problems with the thyroid gland are increasingly found during routine medical exams and affect millions of Americans.  A “goiter” is a generic term used to describe an enlarged thyroid gland that may be causing symptoms.  Thyroid nodules are extremely common and are usually diagnosed during a neck exam or from imaging studies.  Nodules are classified as either benign (non-cancerous) or malignant (cancerous) types.  About 90% of nodules turn out to be non-cancerous.  Malignant nodules are treated by a total thyroidectomy and postoperative radioactive iodine therapy.  Dr. Gunnlaugsson is experienced in treating thyroid nodules and performs thyroidectomy surgery when it is required.

WHAT IS THE THYROID GLAND?
The thyroid gland is one of several endocrine glands in your body that makes hormones to regulate the body’s physiological functions and metabolism.  Other endocrine glands include the pancreas, pituitary gland, adrenal glands, and the parathyroid glands.

The thyroid gland is located below the voice box (larynx) in the middle of the neck and wraps around the front half of the windpipe (trachea).  It is bow tie shaped and splits into two halves called lobes.  The two lobes are joined together by a small tissue bar called the isthmus.  Located just above the collarbone, you may or may not be able to feel a normal thyroid gland.  In some individuals, the entire thyroid gland diffusely enlarges due to abnormal chemical signaling and a goiter develops.  A large goiter can be easily palpated or even visually seen on a neck exam.

Nodules are typically noticed as a palpable lump in the neck.  Many nonpalpable nodules are incidentally found due to radiologic studies such as ultrasounds or CT scans.  As nodules or the entire thyroid gland enlarges, pressure is exerted on the normal structures of the neck.  This pressure can lead to impaired swallowing or difficulty with breathing.  Upon discovery of a large nodule or thyroid gland, the evaluation focuses on determining whether or not surgical removal is required.  This is typically done with ultrasound studies, needle biopsies, or radioactive iodine studies. 

COMMON SYMPTOMS OF A THYROID DISORDER
If you develop swelling in the neck or have difficulty breathing or swallowing, you should see an ENT specialist such as Dr. Gunnlaugsson for evaluation.

The most common symptoms of thyroid disease include:

• Problem with swallowing or breathing due to an enlarged thyroid gland
• A lump in the middle portion of the neck
• Hyperactivity of the thyroid gland leads to heart palpitations and weight loss
• Hypoactivity of the thyroid gland leads to fatigue and hair loss

MOST COMMON THYROID PROBLEMS
Disorders of the thyroid gland are very common and affect millions of Americans.  People with a family history of certain thyroid disorders or those who have had radiation therapy as children to the head and neck (e.g. to treat acne, adenoids or for other reasons) are at higher risk for developing thyroid cancer.

The most common thyroid problems include:

• An overactive thyroid gland (hyperthyroidism) due to autoimmune disease (Grave’s Disease) or hyperfunctioning nodules.
• An underactive thyroid gland (hypothyroidism) due to autoimmune disease (Hashimoto’s Thyroiditis).
• Thyroid enlargement due to benign conditions (e.g. nodules, autoimmune disease, abnormal chemical signaling) or malignancy.

TREATMENT FOR THYROID DISORDERS
The type of treatment is determined by the disorder involved.  Dr. Gunnlaugsson specifically treats patients with thyroid cancer who require surgical removal of the gland.  Dr. Gunnlaugsson also performs thyroidectomy for enlarged goiters that are causing airway or swallowing symptoms.  Patients with thyroid nodules are typically evaluated using ultrasound scans and a needle biopsy.  Thyroidectomy for a thyroid nodule is usually required when: 1) the fine needle biopsy results are suspicious for or suggest cancer, or 2) When the trachea or esophagus is compressed due to an enlarged thyroid nodule.  The risks of thyroid surgery include damage to the vocal cord nerves with subsequent voice impairment and damage to the parathyroid glands resulting in the need for calcium replacement.  These risks are decreased in the hands of an experienced surgeon.  Dr. Gunnlaugsson has extensive experience performing thyroidectomy surgery and thyroid nodule evaluation.  He customizes the treatment plan to each individual patient and uses specialized equipment (nerve monitors) to help minimize the potential risks of surgery.