Who needs a thyroidectomy?

The thyroid gland is located in the front part of the neck below the Adam’s Apple.  It has two lobes, one on the left and one on the right.

Thyroidectomy refers to the removal of one lobe of the thyroid gland (called a hemithyroidectomy) or both lobes of the thyroid gland (called a total thyroidectomy).

Hemithyroidectomies are usually performed to diagnose whether a suspicious thyroid nodule may be cancerous or not.

Total thyroidectomies are performed to treat:

  • Goitre (enlarged thyroid gland)
  • Thyroid cancer
  • Thyrotoxicosis (overactive thyroid gland) in patients who don’t wish to or can no longer take medication to control their disease

 What are the risks of a thyroidectomy?

Thyroidectomies are a safe and common procedure but all patients should be aware of the uncommon but specific risks of thyroidectomy including:

  • Postoperative bleeding in the neck  – a blood clot, or haematoma, may collect under the wound  requiring release in the operating theatre
  • Hoarse or soft voice – thyroidectomy can result in temporary bruising of the nerve to the voice box.  Rarely is the damage permanent.  Dr Chong routinely uses an intraoperative nerve monitor (IONM) to assist in checking the integrity of the nerve to the voice box during surgery
  • Low calcium levels – after a total thyroidectomy the four parathyroid glands behind the thyroid can be bruised and temporarily fail to function.  This impairs the secretion of parathyroid hormone (PTH) which causes low calcium levels. The patient may feel tingling in their fingers and lips.  Dr Chong routinely discharges his total thyroidectomy patients on calcium supplements in case this occurs.

 Do I need my thyroid?

The thyroid gland normally secretes thyroxine which is needed for metabolism and temperature regulation.  Patients who have undergone a total thyroidectomy will need to be on  daily thyroxine replacement pill permanently to compensate for the removal of their thyroid gland.

Only 1 in 5 patients who have undergone a hemithyroidectomy need thyroxine replacement in case the lobe that remains doesn’t function fully.