Thyroid & Parathyroid Surgery
About Thyroid & Parathyroid Surgery
Surgical management of thyroid and parathyroid disease involves the management of both benign and malignant diseases of the thyroid and parathyroid glands.
Thyroid surgery is typically performed for diagnostic purposes (i.e. to determine if a cancer is present) or to remove a known cancer from within the thyroid. These types of procedure can involve removal of one half of the thyroid gland or the entire gland and are performed through an incision in the front of the neck.
Parathyroid surgery is most commonly performed for benign tumours of the parathyroid glands, called parathyroid adenomas. These tumours can disrupt calcium metabolism and result in high calcium levels in the blood.
Symptoms of high blood calcium levels include abdominal pain, mood changes, kidney stones, and osteoporosis. Luckily, these benign tumours can be removed through a small incision in the neck and blood calcium levels quickly return to normal.
Further information about Thyroid & Parathyroid Surgery
What investigations do I need for a thyroid lump?
Usually, a set of blood tests to check for your thyroid function to see if your thyroid is over or under active as well as some basic routine bloods.
To look at the lump itself the best test is an ultrasound scan. Occasionally if there is an abnormality in your thyroid function a nuclear medicine scan of the thyroid will be ordered. If there is a suspicious lump in the thyroid then often a biopsy with a fine needle will be arranged.
Are lumps in the thyroid often cancerous?
Thyroid lumps are incredibly common and the vast majority are benign. Only lumps that are suspicious on ultrasound need a biopsy.
Management of the lump will depend on the Ultrasound findings as well as the biopsy result. Most thyroid lumps do not require surgery. If it is suspicious for cancer on a biopsy then sometimes half the thyroid is taken to check.
What are the risks of thyroid surgery?
As with all operations there are rare risks to surgery.
There will be a scar on the neck and rarely you can get wound problems such as infection. Running either side of the thyroid gland is the recurrent laryngeal nerve which supplies muscles in the voice box. If one of these nerves is damaged it can lead to temporary or permanent voice change. This risk is about 1 in 100.
There are 4 small parathyroid glands around the thyroid and if all 4 are damaged can lead to permanent hypoparathyroidism which requires calcium and vitamin D replacement for life. This risk is around 1/100 if the whole thyroid is removed.
Also about 1 in 100 there is a risk of an acute bleed after the operation that will require going back and re-opening the wound to sort out.