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What Is An Incision Of The Thyroid Gland Called

What Are The Risks And Potential Complications Of A Thyroidectomy

What Is The Thyroid Gland? | Hyperthyroidism or Hypothyroidism?

As with all surgeries, a thyroidectomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery

  • Damage to the parathyroid glands causing problems controlling your bodys calcium levels

  • Difficulty breathing, which is a rare complication

  • Nerve damage, which can lead to permanent , coughing, swallowing problems, problems speaking, or other voice changes

  • Nerve irritation leading to temporary voice changes, hoarseness or .

  • Temporary rise in the level of thyroid hormones

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery

  • Informing your doctor if you are nursing or if there is any possibility of

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any

Where Is The Incision For Thyroid Gland Surgery

Incision for thyroid gland surgery. Overview. The thyroid is a gland located in the neck. It is a part of the endocrine system, and plays a major role in regulating the bodys metabolism. If surgery or an open excisional biopsy is needed, an incision is made in front of the neck to gain access to the thyroid gland.

Thyroid And Neck Ultrasound

The thyroid is an organ in the lower neck that controls metabolism. Thyroid nodules are sometimes found on exam or on radiologic studies. Most thyroid nodules are benign, but some are cancerous. Initial evaluation of thyroid abnormalities often involves thyroid ultrasound to evaluate the anatomy.

Performed with in-office ultrasound equipment, the procedure requires a soft gel to be spread across the area of the neck to be observed, which will help the sound waves travel between the machine and the body. The procedure itself is completely painless.

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What Does The Thyroid Do

Your thyroid has an important job to do within your body releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your bodys systems working correctly. Think of your metabolism as a generator. It takes in raw energy and uses it to power something bigger.

The thyroid controls your metabolism with a few specific hormones T4 and T3 . These two hormones are created by the thyroid and they tell the bodys cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.

This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone . The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.

Risks Of Thyroid Surgery

Facelift incision. A. Cosmetic outcome of a parotidectomy ...

In the hands of an experienced thyroid surgeon, thyroid surgery is a safe procedure with few complications. The following possible complications are directly related to the operative experience of the surgeon, and these statistics are based on our own results here at Columbia:

Bleeding in the neck:

As with any operation, there is always a chance of bleeding. The average blood loss for this operation is less than a tablespoon and the chance of needing a blood transfusion is extremely rare. However, bleeding in the neck is potentially life-threatening because as the blood pools, it can push on the windpipe or trachea causing difficulty breathing. Fortunately, in the hands of Columbia Thyroid Center surgeons, the risk of bleeding is less than 1%. Due to this rare risk of bleeding, patients are observed for 4 hours by our highly trained recovery room staff. If there is no sign of bleeding and the patient feels well, he or she may go home. Once at home, patients and their friends/family should watch for signs such as difficulty breathing, a high squeaky voice, swelling in the neck that continues to get bigger, and a feeling that something bad is happening. If any of these symptoms happen, the patient should call 911 first and then their surgeon.

Hoarseness :

Hypocalcemia :

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What Does The Thyroid Gland Do

The thyroid, located at the base of your neck, makes a hormone that is sent into your bloodstream. The thyroid hormone controls the speed of your metabolism. The thyroid gland makes this hormone from iodine. Iodine is absorbed from the foods we eat.

The pituitary gland controls how much thyroid hormone to make. It does this by making thyroid stimulating hormone . TSH tells the thyroid gland to make more or less thyroid hormone.

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Developmental Abnormalities Of The Thyroid

To understand the different thyroid anomalies, it is important to briefly review normal development of this gland. The thyroid is embryologically an offshoot of the primitive alimentary tract, from which it later becomes separated . During the third to fourth week in utero, a median anlage of epithelium arises from the pharyngeal floor in the region of the foramen cecum of the tongue . The main body of the thyroid, referred to as the median lobe or median thyroid component, follows the descent of the heart and great vessels and moves caudally into the neck from this origin. It divides into an isthmus and two lobes, and by 7 weeks it forms a shield over the front of the trachea and thyroid cartilage. It is joined by a pair of lateral thyroid lobes originating from the fourth and fifth branchial pouches . From these lateral thyroid components, now commonly called the ultimobranchial bodies, C cells enter the thyroid lobes. C cells contain and secrete calcitonin and are the cells that give rise to medullary carcinoma of the thyroid gland. Williams and associates have described cystic structures in the neck near the upper parathyroid glands in cases in which thyroid tissue was totally lingual in location . These cysts contained both cells staining for calcitonin and others staining for thyroglobulin. This study, they believe, offers evidence that the ultimobranchial body contributes both C cells and follicular cells to the thyroid gland of humans.

Should I Exercise If I Have A Thyroid Disease

Designing, Management, and Care of Your Thyroid Incision for Thyroid Surgery Video

Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your bodys thyroid hormones and it shouldnt hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that its a good fit for you.

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What Are The Risks Of Thyroid Surgery

All surgery brings risk for complications like bleeding and infection. Thyroid surgery can also involve risks for damage to vocal cord nerves, which could cause hoarseness, and damage to your parathyroid glands, which are located behind and very close to your thyroid and regulate your bodys calcium levels.

General Surgeon Specializing In Robotic Surgery Located In Dallas Tx

Endocrine surgery focuses on the thyroid and parathyroid glands located in your neck. With expertise in endocrine procedures, Dina Madni, MD, in Dallas, Texas, provides exceptional surgical care for patients suffering from problems such as an overactive thyroid gland, thyroid nodules, and thyroid cancer. Dr. Madni specializes in minimally invasive surgery while treating the whole patient, following up with you after surgery to ensure youre on the road to wellness. To schedule a same-day or same-week appointment, call the office or use the online booking feature today.

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How Is A Thyroidectomy Performed

Your thyroidectomy will be performed in a hospital or outpatient surgery setting. Your surgeon will perform a thyroidectomy using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through a small incision in your neck. An endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less damage to tissues and organs. Your surgeon will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

  • Open surgery involves making a three to four inch incision in your neck. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

Your surgeon will perform a thyroidectomy using general anesthesia. In some cases, a thyroidectomy may only require local anesthesia.

What to expect the day of your thyroidectomy

Within 30 Days Of Your Surgery

Scarless Thyroid Surgery

Presurgical Testing

Before your surgery, youll have an appointment for presurgical testing . The date, time, and location will be printed on the appointment reminder from your surgeons office. Its helpful to bring the following things to your PST appointment:

  • A list of all the medications youre taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name and telephone number of your healthcare provider.

You can eat and take your usual medications the day of your appointment.

During your PST appointment, youll meet with a nurse practitioner . They work closely with anesthesiology staff . Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

Identify your caregiver

Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when youre discharged from the hospital. Theyll also help you care for yourself at home.

For caregivers


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Should Prophylactic Central Lymph Node Dissections Be Performed

There is agreement that therapeutic central and lateral lymph node dissections should be performed at the time of total thyroidectomy when lymph nodes are suspicious or proved to harbor cancer by sonographic appearance or by FNA analyses preoperatively or when suspicious lymph nodes are found at operation. Prophylactic lateral lymph node dissections were common in the past, but have been abandoned for several decades or longer . Delbridge and his group and others have proposed that unilateral or bilateral prophylactic central lymph node dissections with parathyroid autotransplantation be performed in all cases of papillary thyroid cancer at the time of total thyroidectomy . This, they state, might decrease mortality from thyroid cancer, would greatly decrease recurrence of cancer, and would further clarify who needs radioiodine therapy postoperatively. Some studies by very experienced surgeons demonstrate no increase in hypoparathyroidism or recurrent laryngeal nerve injuries after this procedure, while other equally competent surgeons have found an increase in permanent hypoparathyroidism . We and others have not practiced routine bilateral central lymph node dissections prophylactically, but have generally reserved unilateral dissection for instances in which lymph nodes are clearly involved with tumor . However, recently we have performed some prophylactic unilateral central lymph node dissections when a large carcinoma is present, as well as in some children.

Recurrent Laryngeal Nerve Monitoring

Many surgeons have sought to try to further diminish the low incidence of recurrent laryngeal nerve injury by use of nerve monitoring devices during surgery. Although several devices have been utilized, all have in common some means of detecting vocal cord movement when the RLN or the ipsilateral vagus nerve is stimulated. Many small series have been reported in the literature assessing the potential benefits of monitoring to decrease the incidence of nerve injury . Given the low incidence of RLN injury, it is not surprising that no study has shown a statistically significant decrease in RLN injury when using a nerve monitor. The largest series in the literature by Dralle reported on a multi-institutional German study of 29,998 nerves at risk in thyroidectomy . Even with a study this large, no statistically significant decrease in rates of RLN injury could be shown with nerve monitoring. Despite this, the use of nerve monitoring has become more popular.

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What Is Your Complication Rate

The answer you want to hear is the surgeons own complication rate for the procedurenot the average 1 percent reported in the medical literature. If the surgeon only does two thyroid surgeries a year and one patient had a problem, that makes it a 50 percent risk, said Roman. Dont be shy about asking for this information. Said Sosa, Its the ethical responsibility of the surgeon to report the truth and to know their own data.

Can I Check My Thyroid At Home

Risks of Thyroid Gland Surgery

You can do a quick and easy self-exam of your thyroid at home. The only tools you need to do this self-exam are a mirror and a glass of water.

To do the thyroid self-exam, follow these steps:

  • Start by identifying where your thyroid is located. Generally, youll find the thyroid on the front of your neck, between your collar bone and Adams apple. In men, the Adams apple is much easier to see. For women, its usually easiest to look from the collar bone up.
  • Tip your head back while looking in a mirror. Look at your neck and try to hone in on the space you will be looking once you start the exam.
  • Once youre ready, take a drink of water while your head is tilted back. Watch your thyroid as you swallow. During this test, youre looking for lumps or bumps. You may be able to see them when you swallow the water.

Repeat this test a few times to get a good look at your thyroid. If you see any lumps or bumps, reach out to your healthcare provider.

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How Does The Surgeon Know How Much Thyroid Tissue To Remove During A Thyroidectomy

The amount of thyroid tissue that needs to be removed is determined prior to the surgical procedure. The surgeon works closely with an endocrinologist to determine what areas of the thyroid gland are not functioning normally. Usually thyroid function tests and thyroid scanning are involved to aid in this decision. For cases in which thyroid cancer is suspected, a fine needle aspiration biopsy may also be performed. Using this information the endocrinologist and surgeon determine how much of the thyroid gland is removed.

Hrthle Cell Tumors And Cancer

Hürthle cell tumors are thought to be variants of follicular neoplasms, but others regard them as a totally separate disease entity . They are more difficult to treat than the usual follicular neoplasms, however, for several reasons : 1) the incidence of carcinoma varies from 5.3% to 62% in different clinical series 2) benign-appearing tumors later metastasize in up to 2.5% of patients and 3) Hürthle cell cancers are far less likely to concentrate radioiodine than are the usual follicular carcinomas, which makes treatment of metastatic disease particularly difficult.

The difficulty in diagnosing Hurtle cell cancers and differentiating them from benign lesions is shown in the following study. Of 54 patients with Hürthle cell tumors whom we treated, four had grossly malignant lesions . But during a mean follow-up period of 8.4 years, three additional Hürthle cell tumors were recognized as malignant after metastases were discovered. Thus, 7 of 54 of our patients who had a Hürthle cell tumor had Hürthle cell carcinoma. One of the seven patients with Hürthle cell cancer died of widespread metastases after 35 years, and the other six were currently free of disease.

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