Thyroidectomy

Thyroidectomy is the surgical removal of part or all of the thyroid gland. It is performed under general anaesthetic by a head and neck or endocrine surgeon, usually through a small horizontal incision in the lower neck.

The extent of surgery depends on the underlying condition. A total thyroidectomy removes the entire gland and is used for thyroid cancer, large goitres, and sometimes Graves' disease. A hemithyroidectomy removes one lobe when a nodule or concern is confined to that side. An isthmusectomy removes only the narrow isthmus, used when a nodule is located specifically there.

Risks include bleeding, infection, and two important structures adjacent to the thyroid: the recurrent laryngeal nerve (injury can cause a hoarse or changed voice) and the parathyroid glands (four tiny glands behind the thyroid that regulate calcium; inadvertent damage can cause low calcium levels).

After a total thyroidectomy, lifelong levothyroxine is required. After hemithyroidectomy, the remaining lobe may produce sufficient hormone, but some people develop hypothyroidism over time.