Based on the results of your diagnosis, we may recommend surgery as your best option for treatment. Before your surgery is scheduled, we explain the reasons for our recommendation. We consult with you and listen to your concerns. Treating you for the best possible outcome, we provide a personal treatment plan for you, taking into consideration your quality of life following surgery.
Types of Thyroid Surgery
We encourage you to discuss with your surgeon your condition, your prognosis, and the type of surgery you need. Our surgeons have extensive experience in performing the following types of thyroid surgery:
- Total thyroidectomy—removing your entire thyroid gland may be the best way to treat thyroid cancer, Graves’ disease, and goiter under certain circumstances. To replenish your thyroid hormones, you will need to take a thyroid hormone medication.
- Thyroid lobectomy—also referred to as hemi thyroidectomy, this procedure involves removing half of the thyroid gland to treat thyroid conditions such as nodules and goiter. With half of your thyroid gland in place, you may not need to take hormone replacement medication, depending on the ability of your thyroid to regulate your hormone levels.
Our surgeons use the safest and most effect techniques during surgical procedures. We are happy to explain the techniques we will be using during your procedure.
- Anesthesia—during thyroid surgery you may have either general or local anesthesia. Your surgeon will discuss the difference with you, and depending on the type of surgery and your preferences, we will advise you about the type of anesthesia that is right for you.
- Open thyroid surgery—the typical incision made for thyroid surgery runs several inches along your neck above your collarbone, so that your surgeon can easily access the area of your thyroid gland and nearby tissue for possible further diagnosis and treatment. To minimize scarring if needed, we can perform follow up reconstructive procedure, at your discretion.
- Minimally invasive thyroid surgery—in this type of surgery, the surgeon makes small incisions using special techniques to reach the area of your thyroid gland. Your surgeon may be able to camouflage the incision along the natural creases of your neck.
- Innovative Procedures—our surgeons are at the forefront of innovation with hidden-scar surgery. These minimally invasive thyroid techniques can be performed without leaving a visible scar on the neck. We are one of the few programs in the world to offer several hidden-scar approaches to thyroid gland removal, including transoral, breast, and transaxillary (armpit) approaches. Our surgeons are at the forefront of innovation. Carefully selected patients may be eligible for hidden-scar surgery.
Lymph Nodes in Thyroid Cancer Surgery
Lymph nodes are structures that are part of the body’s lymphatic system and act as filters in that system. There are roughly 150 lymph nodes on each side of the neck as well as between 10 and 40 nodes in the central portion of the neck. In some cases, thyroid cancer can spread to these lymph nodes. The degree of lymph node involvement may influence your treatment.
Lymph nodes are the most common site of recurrent disease following initial therapy. The management of your thyroid cancer may involve surgical removal of your lymph nodes. Your lymph nodes are located in the central compartment of the neck (next to your thyroid gland) or in the lateral compartments (located in the side of your neck).
Before your surgery, we may identify diseased lymph nodes using ultrasound and possibly a biopsy. If we discover that the cancer has metastasized (spread), we will perform a more comprehensive lymph node removal. The surgeon identifies some lymph node disease during thyroid surgery. The pathologist who analyzes the tissue discovers other lymph node disease after surgery.
Our Thyroid Center has extensive experience detecting and surgically removing lymph nodes during your initial thyroid surgery. We are also experts at treating disease that recurs following therapy. We encourage you to meet with our clinicians if you are experiencing these conditions. We can help you; it’s our area of expertise.
Preservation of Vocal Function
Thyroid Center surgeons have the experience needed to help preserve your vocal function during surgery. A significant risk associated with thyroid and parathyroid gland surgery is damage to the nerves that control the function of the voice box (larynx). These nerves control your normal conversational voice and your ability to change the pitch and volume of your voice.
In addition to a surgeon’s level of experience contributing to a good outcome, the use of sophisticated monitoring equipment during surgery can help to protect your vocal function. At our Thyroid Center, we are developing novel approaches to monitoring. We believe that our discovery holds great promise to revolutionize how we protect your voice.
If you have any voice or swallowing disturbance when we examine you, we will recommend that you undergo an examination of your vocal cords with a fiberoptic laryngoscopy (a tiny camera is inserted through the nostrils to view vocal cords). In addition, to protect these vital nerves, our surgical experts are able to identify a nerve injury and take the appropriate steps at the time of that surgery in order to help to correct the injury.
Management of Invasive Thyroid Cancer
Our Thyroid Center experts are highly skilled in treating invasive thyroid cancer and achieve the best outcomes for our patients.
If you have a more advanced form of cancer, or if your cancer has recurred, you may have a more invasive form of the disease. Invasive thyroid cancer spreads beyond the thyroid gland or the associated lymph nodes. Surrounding structures, such as your trachea, larynx and esophagus, carotid artery and jugular vein may be affected. Nerves to the vocal cords are often at risk as well. We use appropriate imaging before surgery to identify if you may have this more aggressive form of thyroid cancer.
However, we may discover this invasive form of the disease during surgery, which requires expert management of the involved structures. It is our surgeon’s goal to restore function of the structures involved, while reducing the risk of local cancer recurring. We will repair the trachea, larynx, and esophagus to preserve normal breathing, voice, and swallowing.
Before, during and after thyroid surgery, we are here for you, monitoring your recovery, and ensuring that you have the long-term care that you need. Our Thyroid Center and our doctors remain your go-to medical team for you for life.