| A thyroidectomy is the partial (partial thyroidectomy) or complete (total or subtotal thyroidectomy) removal of the thyroid gland. Total thyroidectomy is a technically challenging procedure with potentially serious complications. Partial thyroidectomy or hemithyroidectomy are considered safe, effective treatments for certain less severe thyroid disorders.
The thyroid gland is responsible for normal physical growth and development in childhood, as well as maintaining normal metabolic energy production and utilization in adults. Thyroid dysfunction, either elevated or decreased function, can be found in 11.7% of the general population in the US (Bansal).
The thyroid gland may have to be removed for a number of reasons. Both noncancerous and cancerous (benign and malignant) tumors can develop in the thyroid and thyroidectomy may be required to remove the tumors or the entire thyroid gland. Diseases such as Graves' disease, toxic nodular goiter or larger goiters, thyroid nodules, thyroiditis, and thyrotoxicosis may also be treated with thyroidectomy.
Low-dose radiation in infancy is a risk factor for developing thyroid cancer later in life. |
Source: Medical Disability Advisor
| Thyroidectomy is done to remove benign and malignant thyroid tumors, to relieve breathing difficulties (airway obstruction) or blood vessel obstruction caused by an enlarged thyroid gland (goiter), or to treat hyperthyroidism, especially if the individual is pregnant or trying to become pregnant.
Partial thyroidectomy or video-assisted hemi-thyroidectomy may be performed for a dysfunctional thyroid associated with Grave's disease, thyrotoxicosis, thyroiditis, or thyroid nodules.
Thyroidectomy for known or suspected thyroid cancer involves performing a total thyroidectomy. |
Source: Medical Disability Advisor
| A thyroidectomy may involve removing part or all of the thyroid gland (partial or total thyroidectomy). This surgical procedure is performed in the operating room under general anesthesia. A curved incision is made on the front of the neck, blood vessels are tied off or rerouted, the area is suctioned, and the thyroid gland is located. All (total) or part (lobectomy) of the thyroid gland is then removed (resected). The neck incision is closed with stitches. The individual usually stays in the hospital for 1 to 2 days. Follow-up thyroid function tests are required after thyroidectomy to evaluate functioning of the parathyroid glands and any remaining thyroid tissue.
A minimally invasive form of the surgery (hemi-thyroidectomy) can sometimes be performed for individuals with less severe thyroid conditions. The surgery requires only a small incision and uses videoscopic technique to guide the surgical instruments and view the procedure. |
Source: Medical Disability Advisor
| Thyroidectomy for a solitary thyroid nodule reveals cancer in about 20% of individuals. If the nodule was localized to one side of the thyroid gland, then the partial thyroidectomy was sufficient and no further surgery is likely necessary. If the location was more intermediate, or the nodule was quite large, a second surgery for completion of a total thyroidectomy may be performed.
The prognosis of a total thyroidectomy depends on the type of cancer. Papillary thyroid cancer, the most common type, has a favorable prognosis with up to 60% survival 30 years after the surgery. Undifferentiated (anaplastic) thyroid cancer has a poor prognosis, with only a 15% survival rate at 10 years after surgery. Follicular cancer of the thyroid is intermediate in prognosis, with a survival rate of about 35% after 30 years. If there is no spread of the tumor, surgery is all that may be necessary. Spread of the tumor will require radioactive iodine treatment after surgery.
Thyroidectomy for hyperthyroidism or Graves' disease usually results in a cure, although recurrence is possible and treatment with radioactive iodine may be necessary.
All individuals undergoing a total or subtotal thyroidectomy will require lifelong treatment with thyroid hormone replacement.
The individual must be careful not to engage in active sports for a few weeks after the surgery until the incision has healed. |
Source: Medical Disability Advisor
| Total thyroidectomy has been shown in studies to be associated with complications such as hypocalcemia (in up to 40% of individuals), unintentional removal of the parathyroid gland (9%), temporary or permanent paralysis of the laryngeal nerve that controls the voice box (0.5% to 3%, respectively), and rare deaths (0.08%) (Bansal). Thyroid cancer is most prevalent, being found in 40 of 100,000 individuals each year in the US. Injury to the parathyroid glands will require treatment with vitamin D and supplemental calcium, which may become necessary over the individual’s lifetime. Injury to the recurrent laryngeal nerves results in hoarseness, either temporarily or permanently. Hematoma (bleeding under the skin), hemorrhage, and wound infection may also occur with either partial or complete thyroidectomy.
Transient low functioning of the parathyroid glands (hypoparathyroidism) and hoarseness are common after thyroidectomy and almost always resolves spontaneously. |
Source: Medical Disability Advisor
| Hoarseness, sore throat, or difficulty speaking may require work accommodations. If the individual has cancer, radiation treatment may be required after surgery, requiring frequent absences from work. |
Source: Medical Disability Advisor
| Bansal, Arvind, Jeffrey Miskoff, and Ronald J. Lis. "Otolaryngologic Critical Care." Critical Care Clinics 19 1 (2003): 55-72. MD Consult. Elsevier, Inc. 8 Oct. 2004 <http://home.mdconsult.com/das/journal/view/41461313-2/N/12920764?sid=305345245&source=MI>. |
Source: Medical Disability Advisor