Thyroid surgery: Types, recovery, and more

The thyroid gland is a butterfly-shaped organ located in the neck that regulates metabolism, energy levels, and hormonal balance. When issues arise with the thyroid, surgery may become necessary.

This article provides a detailed overview of thyroid surgery, answering common patient questions to help you make informed decisions.

When is thyroid surgery performed?

There are several reasons why your ENT specialist might recommend thyroid surgery:

• Thyroid nodules: Abnormal growths in the gland. Many thyroid nodules are benign, but some can become cancerous or cause discomfort.
• Goitre: An enlarged thyroid, which can lead to difficulties with swallowing or breathing. Large goitres can compress surrounding structures in the neck, causing significant discomfort.
• Hyperthyroidism: An overactive thyroid. In cases where medication or radioactive iodine therapy fails to control the condition, removing part or all of the thyroid gland can help restore hormone balance.
• Thyroid cancer: Removing the thyroid is often the first step in treatment.

What are the different types of thyroid surgery?

The main types of thyroid surgery include:

Lobectomy: A lobectomy is usually performed for thyroid conditions (like nodules) that are confined to a single lobe of the thyroid gland. During this procedure, your ENT specialist will make an incision at the base of the neck. The affected lobe will then be carefully separated and removed.

Subtotal thyroidectomy: A subtotal thyroidectomy is usually performed for goitres or hyperthyroidism. During this procedure, your ENT specialist will remove most of the thyroid gland, leaving a small portion intact to preserve some thyroid function.

Total thyroidectomy: A total thyroidectomy is necessary for cases of thyroid cancer or severe hyperthyroidism. During this procedure, your ENT specialist will remove the entire thyroid gland, while protecting the surrounding nerves and parathyroid glands.

In recent years, minimally invasive surgical techniques such as endoscopic or robotic-assisted thyroidectomy have become available, reducing scarring and recovery time after thyroid surgery.

How long does recovery take after thyroid surgery?

Recovery will vary depending on the type of thyroid procedure, but most patients will return to regular activities within 1-2 weeks. After surgery, it’s normal to experience mild discomfort, swelling and a sore throat, which will typically subside within a few days.

The incision site will result in a scar that may be noticeable at first but will gradually fade over time. Additionally, your ENT surgeon will take care to make the incision in a natural skin crease, minimising its visibility. Using sunscreen and scar-reducing creams will also help improve the appearance of the scar.

Will I need to take medications after thyroid surgery?

The need for medication after thyroid surgery will depend on how much of the gland was removed.

If you undergo a total thyroidectomy, you will require lifelong thyroid hormone replacement therapy to ensure your thyroid hormone levels remain balanced. Levothyroxine, a synthetic thyroid hormone, is the most common medication prescribed.

If only part of your thyroid gland is removed, your remaining thyroid tissue may produce sufficient hormones, and medication may not be necessary. However, regular monitoring of thyroid function through blood tests will be required to ensure proper hormone levels.

For patients who had surgery to treat thyroid cancer, additional treatments may be required, such as radioactive iodine therapy, to remove any remaining cancerous cells. In these cases, your ENT specialist will create a tailored treatment plan to address your specific needs.