Frequently Asked Questions About Thyroid Surgery, Surgery Recovery and Surgery Risks
Thyroid Surgery FAQs: Which thyroid operation do I need?
- The extent of thyroid surgery performed depends on the specific thyroid condition being treated
- The goal is to treat the condition to the best extent possible, while maintaining the lowest risk
- Surgery will be recommended if the condition cannot be adequately treated medically, i.e. if cancer is found or suspected, if the airway is obstructed, or if medical treatment is unsuccessful
- Depending on the specific condition, the extent of thyroid surgery will vary from removing only one lobe of the thyroid, or half of the gland (this procedure is called a thyroid lobectomy or hemithyroidectomy – to removing the entire thyroid, called a total thyroidectomy
- Thyroid surgery may be performed through a standard neck incision or by a mini-incision (minimal access thyroid surgery) depending on the underlying thyroid condition
- Sometimes the extent of surgery must be determined during surgery when the features of the thyroid disease can be seen directly
- If the thyroid is cancerous, the entire gland as well as the lymph nodes close to the thyroid gland may need to be removed to reduce the risk of metastases
- When surrounding lymph nodes are removed, the operation is called a neck dissection
How long will I stay in hospital after thyroid surgery?
Most patients come to the hospital on the morning of their surgery. Although an overnight bed is automatically reserved for each patient, the majority of patients go home the same day after a 6 hour observation period in the recovery room
What type of anaesthesia will I have for my thyroid operation?
- Usually a combination of general anaesthesia and local anaesthesia is used for thyroid surgery
- With general anaesthesia you are completely asleep during the operation
- With local anaesthesia the neck area is numbed to help eliminate any post-operative discomfort
What is the recovery like after thyroid surgery?
- Immediately after surgery you will be sleepy for the first few hours
- You will be nursed with the head and neck supported to reduce swelling and strain on the neck
- Your nurse will show you how to do breathing and coughing exercises to reduce the risk of developing a chest infection
- An IV line will provide fluid until you are able to drink
- Most people recover reasonably quickly from thyroid surgery
Thyroid Surgery Recovery: Will I have any physical restrictions after my surgery?
- In general, your activity level depends on the amount of discomfort you experience
- Many patients have resumed golf or tennis within a week after the operation
- Most patients are able to return to work within the first or second week of surgery, and you are able to drive as soon as your head can be turned comfortably
- You should restrain from driving if you are taking narcotics for pain control – for driver safety
- You must see your local doctor one week after surgery and see your surgeon for a routine follow-up office visit two to three weeks after surgery
- You need to call to make these appointments
Will I have pain after my thyroid operation?
- All operations involve some pain and discomfort – the goal is to minimize this discomfort
- At the time of operation, your anaesthetist will give you some numbing medicine which usually lasts about eight hours
- Although you should be able to eat and drink normally, the most common complaint is pain with eating and drinking
- Most patients take Panadeine® or Panadeine Forte® to keep them comfortable at home
Will I have stitches?
- Dissolving sutures are typically used and the incision is covered with a tape
- It is best to keep the wound dry for the first 5 days after surgery
- At the first visit after thyroid surgery the Steri-Strip dressing will be removed – for best results a skin coloured micropore tape may then be applied each day for up to six weeks following the operation.
Thyroid surgery scar – will I have a scar?
- Yes – all surgery causes scarring, and how the patient heals the scar is very much dependent on the individual
- There are some techniques that may minimize scarring – these techniques include using a smaller incision size and carefully placing the incision in a skin crease
- Appropriate post-operative wound care including using regular vitamin E cream and taping the incision for the first six weeks will reduce scarring
- Generally with appropriate wound care the scan will not be noticeable after six months
When will I know the findings after surgery?
The final pathology report requires careful study of the surgical specimen – therefore, the final report is usually not available until about one week after the operation
Thyroid Surgery Risks: What are the complications unique to thyroid surgery?
- In about 1 in 100 thyroid operations, the nerves that control the voice are affected by the surgical removal of the thyroid – this may be temporary or permanent
- When this occurs, the main difficulties are projection of the voice and production of high pitched sounds
- It is usually described as hoarseness, but will not necessarily be considered abnormal by strangers
- Usually, voice changes are temporary, so the voice will return to normal within a few weeks; permanent change is rare
- In about 1 in 300 thyroid operations, the parathyroid glands will not function as a result of surgery
- The parathyroids are four delicate glands that are located near the thyroid
- Since the parathyroid glands control calcium levels, their dysfunction usually results in a lowered calcium level – therefore, some patients require calcium supplements on a temporary basis
- If the parathyroids do not function properly, calcium or vitamin D may be needed on a permanent basis
- As with any operation, there is a risk of bleeding – in the case of thyroid and parathyroid surgery, the risk is 1 in 300 patients
- Because of the rare chance of bleeding, patients are managed in hospital for 4 to 6 hours after the operation for observation and in certain cases overnight
Thyroid hormone replacement
- If you have a total thyroidectomy you will need to take thyroid hormone replacement medication for the rest of your life
- Often patients who have most of the thyroid removed may need temporary or permanent thyroid hormone supplements
- Regular blood tests are needed to make sure the dose of thyroid medication is appropriate
If you have any questions about thyroid or parathyroid surgery, you should speak to your local doctor, who will arrange to contact your thyroid surgeon.