When Is Thyroid Surgery Necessary?

Many types of thyroid conditions can be successfully treated using means other than surgery such as medication or radio-iodine. In some instances, surgery is the best option, in others it may be the only option available. Surgery is usually not the first option if noninvasive treatment could be used instead.

Nodules are a common reason for thyroid surgery. The doctor my try removing fluid and using medication to shrink the nodule but if these treatments don’t work, then surgery is the next choice. If the nodule is a source of anxiety or pain for the patient, the doctor may decide to go ahead and perform surgery to remove it. Doctors usually agree that a nodule with a diameter over four centimeters should be removed.

Nodules that stimulate overproduction of thyroid hormone are called “Hot Nodules” and these are treated with surgery or radio-iodine. Because some patients are fearful of radioactive iodine therapy, doctors may elect to perform the surgery for the patient’s peace of mind. The incidence of developing hypothyroidism as a result of removing a nodule is fairly low so choosing to do surgery carries a fairly low risk.

Multi nodular goiters can occasionally be treated with means other than surgery but sometimes surgery becomes necessary. If the goiter continues to grow larger despite medical treatment or if it becomes toxic, it may need to be surgically removed.

Patients may elect to have goiters removed for cosmetic reasons if it has grown large enough to become a visible lump. Goiters that interfere with normal bodily functions must be removed such as when they compress the trachea or begin to compress an artery. These goiters can cause respiratory infection, blockage of the respiratory tract, reduced blood flow or stroke.

Thyroid cancer is the main reason for thyroid surgery. In some cases, a partial thyroidectomey may be performed. Normally, doctors will opt for a total thyroidectomy in order to prevent the cancer from returning or spreading. The cancer may have metastasized before the thyroid was removed therefore thyroid surgery for cancer is often combined with other cancer treatments like radiation or chemotherapy.

A partial thyroidectomy might be done on a patient with a follicular or papillary cancer that is in T1 stage and less than a centimeter wide. Anaplastic and medullary cancers and large follicular or medullary tumors commonly result in a total thyroidectomy. Removal of the whole thyroid will require that the patient takes thyroid hormone replacement medication on a daily basis for the rest of his life.

All surgical operations carry some risk and there is also risk to thyroid surgery although the risks are small compared to other surgeries. The general risks include infection, reaction to anesthesia and excessive bleeding. The risks specific to thyroid surgery include hoarseness which could be permanent due to damaged laryngeal nerves and hypothyroidism which would require permanent medical treatment. In all, thyroid surgery is relatively safe and is usually a straightforward procedure.

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