The thyroid is a butterfly-shaped gland in the front of the neck. It is divided into two sections or lobes that lay against the sides of the esophagus, connected by a bridge (isthmus). The thyroid produces the hormone thyroxine, which is in charge of the body’s metabolic system (the energy system). In some cases, abnormalities of the thyroid may require the removal of half or all of the thyroid, a procedure known as thyroidectomy.
 
Thyroid Nodules
       Most thyroid nodules are benign (non-cancerous) and only a small percentage are cancerous.

1. Benign nodules include:

• Cysts or fluid-filled lumps
• Ordinary nodules within the thyroid that are usually small and don’t place pressure on nearby organs
• Nodules that occur due to inflammation or infection of the thyroid, such as abscesses

2. Malignant tumors or thyroid cancer

These may originate from the thyroid or are metastatic cancer from another part of the body. The appearance, size, and growth rate of cancerous nodules depend on the pathology of the cells. Some cancerous thyroid nodules grow very quickly and will push against nearby organs and the cancer cells will spread to nearby lymph nodes.
 

A thyroidectomy is performed under general anesthesia, which requires additional testing, including blood tests, chest x-ray, and electrocardiogram (EKG) to ensure that the patient can safely undergo the procedure. The patient will be asked to avoid food and water for at least six hours before the surgery or as recommended by the doctor. If the patient is not feeling well and has an infection or a cold, the procedure may be postponed. The patient should get enough sleep the night before the procedure.

Certain medications will have to be stopped weeks before the surgery, such as products containing aspirin and other anticoagulants. Please inform your doctor of all medication that you take regularly well in advance of the procedure.

The patient will have to stay at the hospital one night before the procedure so the anesthesiologist can prepare the patient for surgery. The night before surgery the patient’s skin will be prepared. The patient will have to fast after midnight to prevent aspiration when under general anesthesia.
 

The patient will be placed under general anesthesia and incisions will be made in the neck to remove the thyroid. The incisions will then be sutured close.
 

1. A patient who undergoes a total thyroidectomy will have to take thyroxine for the rest of their life.
2. The patient must undergo regular blood tests to ensure that thyroxine levels are maintained.
3. A patient who undergoes a partial thyroidectomy, but whose remaining thyroid does not function normally, will also need to take thyroxine.
4. Keep the bandage dry for at least 48 hours after the surgery.
5. Contact the doctor or hospital immediately if the surgical site becomes red and /or painful.

A thyroidectomy is considered safe, but as with all surgery, there are complications that occur infrequently and are usually temporary.

1. The procedure can sometimes affect the nerves of the larynx, which is located close to the thyroid. This can cause hoarseness which will improve after three days to two weeks. Some patients may never be able to sing very high notes after that.
2. A total thyroidectomy can affect the parathyroid, which regulates the calcium levels in the body. The patient may need to take calcium and Vitamin D supplements to maintain the appropriate calcium levels. Some patients may have to take these supplements permanent and must undergo regular blood tests. However, this complication does not occur during partial thyroidectomy.
3. Bleeding under the incisions can cause swelling and some patients may have to undergo another surgery to stop the bleeding and drain the collected blood. This is a rare complication.
4. Infection, which will require antibiotics.

 
 

• If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
• Travelers to Thailand should plan to stay in the country for at least one week or for the entire duration of treatment.
• If you plan to return home after the procedure, please speak to your doctor before making travel arrangements.
• During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
 
What if this procedure is not performed?
Health problems may become severe enough to impact daily life. Nodules may grow enough to put pressure on the airway or esophagus, making it difficult to breathe or swallow.
 

The treatment of thyroid disorders is complicated and takes time. When a problem is discovered the doctor will consider treatment methods to reduce the amount of hormones produced by the thyroid gland.

1. The use of medication to reduce the amount of thyroxine produced.
2. Radioactive iodine therapy to stop the function of the thyroid and reduce its size.
3. Partial or complete thyroidectomy, which is usually done for young or elderly patients at risk of developing Graves’ Disease, an immune system disorder that results in the overproduction of thyroid hormones.