If a patient has symptoms of blockage or a nodule or enlargement is palpable an Ultrasound is usually the first test. A needle biopsy may be performed if a suspicious area is noted. Most often this is performed with US guidance, and a small (25 gauge) needle. Clusters of cells from the biopsy are examined by the pathologist. Sometimes cancer is identified or a benign goiter is diagnosed. Other biopsies may have an inadequate sample of cells or a follicular tumor that may be benign or cancerous identified. Molecular testing may be done on samples if they are not diagnostic on cytology. The decision about surgery will be discussed with the patient after review of the biopsy findings along with the size and character of the tumor seen on the scans, and extent of symptoms.
Surgery is curative 95-98% of the time. Papillary and follicular thyroid cancer, even when it involves lypmh nodes, is cured with surgery and radioactive iodine pills over 90 % of the time. Difficulty swallowing from goiters resolves shortly after surgery. This operation is usually be done through a very small (less than 2 inch) neck incision and general anesthesia is usually given. Sometimes regional or local anesthesia in combination with sedation can be used. Almost all patients are discharged the same day. Patients may not drive for 5 days following surgery. Pain medication is prescribed but many patients just use tylenol for the pain. A sore throat for a few days is not uncommon due to the breathing tube used for general anesthesia. One suture in the skin is removed prior to patients discharge 4-6 hours after surgery is completed. Drains are not used. Thyroid hormone pills are given if the entire gland is removed.
A calcium level is checked the morning following surgery and 1 week after surgery. Calcium supplements such as Tums or Citracal are taken after total thyroidectomy, 1500 mg or 1.5 grams for one week. At 4-5 weeks after surgery a TSH levels is checked and adjustment to the dose made if needed.
For more information please see the patient education site for thyroid disease at the American Association of Endocrine Surgeons or Call the office at 304-225-7549.
Patients traveling from out of state or many hours away can be accommadated. Please call or email us at firstname.lastname@example.org for more information.
Surgery is performed on the Thyroid to treat or diagnose cancer and to relieve symptoms from nodules or an enlarged thyroid which is often called a goiter. The symptoms from a nodule or goiter are related to swallowing, breathing and the quality of the voice. Symptoms of overactive and underactive thyroid (hyper or hypothyroidism) are very rarely related to the nodules or thyroid enlargement requiring surgery. After surgery thyroid hormone pills will maintain normal weight, energy and metabolism and blood tests will confirm normal level of function.