Frequently Asked Questions About Thyroid Surgery
Below you will find some of the more frequently asked questions about thyroid surgery. Please take a moment to review them and talk to your physician to learn more about your thyroid disease and surgery. Although each individual patient will have different needs, most patients follow these guidelines for their operative course. Your surgeon will discuss your individual needs at the time of your pre-operative consultation. If you find that you have additional questions after your consultation, it is a good idea to write them all down before speaking to your surgeon.
What type of anesthesia will I have for thyroid surgery?
Thyroid surgery can be performed under two types of anesthesia: general or local anesthesia. With general anesthesia, an endotracheal tube is carefully placed in your airway and you are completely asleep during the operation. With local anesthesia, you receive intravenous sedation and your neck area is numbed with a local anesthetic. With the local anesthesia approach, patients are kept in a "twilight" state during surgery and usually have no recall of the operation. Either approach is safe and allows for same-day discharge.
How will my voice be monitored during surgery?
Voice monitoring can be performed by having patients speak during thyroid surgery while under local/regional anesthesia. In some circumstances, your surgeon may use intra-operative nerve monitoring during your surgery, but this approach requires a general anesthesia.
How long will I be hospitalized?
Depending on the time you undergo thyroid surgery, the type of anesthesia you have, and your condition after surgery, you may be kept in the hospital overnight. Most patients are admitted to the hospital on the morning of their surgery and can go home the same day after a four-hour observation period in the recovery room.
Will I have pain after the operation?
All operations involve some pain and discomfort. Our goal is to minimize this discomfort. At the time of operation, your surgeon will give you some numbing medicine, which usually lasts about four hours. Although you should be able to eat and drink normally, the main complaint is discomfort with swallowing. Most patients take Tylenol® or Motrin® to keep comfortable at home.
Will I have stitches?
Your incision will be closed with a single suture under the skin and may be covered with a special kind of skin glue. The skin glue is waterproof so that you can shower as usual (but do not submerge the incision for 5 days). The coating will peel off on its own within seven to ten days and a moisturizer can be applied to the wound at that time.
Will the thyroid surgery leave a scar?
Yes, all surgery causes scarring, and how a patient scars is dependent on the individual. However, there are minimally invasive thyroid surgery techniques that leave no scarring. These techniques include smaller incision size, careful incision placement, and hypoallergenic suture materials (to avoid inflammation). As a general rule, it is unusual for adults to have a noticeable scar after six months. Please apply sun block to your scar for the first year after thyroid surgery.
Will I have physical restrictions after thyroid surgery?
Swimming is the only major restriction. In general, your activity level depends on how much discomfort you experience. Many patients have resumed regular activities within days after the operation. Most patients are able to return to work within the first week, and you are able to drive as soon as your head can be turned comfortably (this limitation is for driver safety).
When should I follow up?
Please call your surgeon's office to make an appointment to be evaluated approximately one to three weeks after thyroid surgery.
When will I know the findings of my thyroid surgery?
During the operation, your surgeon may consult with the pathologist, who will provide a preliminary diagnosis. However, the final pathology report requires careful study of your tissue specimen. Therefore, the final report is usually not available until about one week after the operation.
What are the potential complications unique to thyroid surgery?
In only about one out of 100 thyroid operations, the nerves that control the voice are permanently affected by the surgical removal of the thyroid. When this occurs, the main difficulties are projection of the voice and production of high-pitched sounds. This condition is usually described as a hoarse voice, but will not necessarily be considered abnormal by strangers. In about one in 20 thyroid operations, the patient experiences temporary mild voice changes. When this happens, the voice usually returns to normal within three to six weeks but it can take months.
In about one in 300 thyroid operations, the parathyroid glands will not function as a result of surgery. These are four delicate glands that are located near the thyroid. Since the parathyroid glands control calcium levels, their dysfunction usually results in a lowered calcium level. Therefore, some patients require calcium supplements on a temporary basis. If the parathyroids do not function properly, calcium or vitamin D may be needed on a permanent basis.
Although the risk of these complications cannot be eliminated entirely, they can certainly be minimized in the hands of an experienced thyroid surgeon.
Mount Sinai Union Square
Fax: 212-202-4713 or 212-202-4995
The Garlock Division of General Surgery
5 East 98th Street
3rd Floor (Mail Box 1259)
New York, NY 10029
1470 Madison Ave at 101st Street
3rd Floor (Mail Box 1259)
New York, NY 10029