Professor MD MD hc Guido Schumacher
Thyroid body produces hormones that regulate metabolism, growth of separate cells, bone tissues and body in general.
Volume of thyroid body is about 18 cubic cm in women, and 25 cubic cm in men, and weighs about 12-25 grams. It’s located in the neck between larynx and trachea, under thyroid cartilage, and its shape reminds of a butterfly.
If a person has diseases of thyroid body, some life-threatening conditions can develop. Therefore, if you suspect you have disorders of thyroid body, you should visit an endocrinologist.
Since there are many symptoms of thyroid diseases and conditions, it’s hard to reveal the beginning of disease.
For example, usual premenstrual tension can appear to be a serious complication that’s connected with incorrect hormonal production in women, however, hormonal changes are ignored, and diseases continues progressing.
To diagnose diseases of thyroid body, doctors perform analyses for values T3, T4, TTG and autoimmune process. Besides, the organ itself is checked with the help of instruments and apparatus – ultrasound and MRI examinations are performed.
In order to cure thyroid body, immune system should be restored. Some time ago, there were two major approaches to treatment of thyroid body:
These approaches to thyroid body treatment only help to relieve patient’s symptoms and painful sensations. For instance, an operation allows removing nodes on thyroid body, while use of hormonal medications helps to normalize hormonal level.
However, the reason of disease – disorders of immune system – is not cured, which can lead to recurrence of conditions and development of some other diseases.
Surgery is used to treat the following problems of thyroid body:
Surgery is rarely used to treat hyperthyroid – only in cases when the increased size of nodular goiter complicates swallowing or breathing. Surgery may also be used in case when a patient cannot use antithyroid medications.
Thyroid body can be partially or fully removed depending on the cause of surgery.
The success of thyroidectomy depends on the type of cancer and metastases. Patient may need further treatment in order to prevent cancer reoccurrence.
When a patient was consulted by a surgeon and an endocrinologist and recommended surgical treatment, it’s necessary to choose an optimal date for operation. It doesn’t matter during which season the operation is performed. Some say that patients shouldn’t go through operation during summertime, but, in fact, it can be performed anytime without risks.
There’s no special preparation needed for thyroid body operations, the only requirement is absence of acute and chronic diseases. Upon coming to the clinic, a person goes through analyses (clinical blood analysis, biochemical analysis, urine analysis, blood group, coagulogram, X-ray of chest and, sometimes – additional analyses). After getting the results of analyses, a patient should be examined by his general practitioner and anesthesiologist.
It’s important to get surgeon’s recommendations – he will answer all patient’s questions. Before the operation, ultrasound of thyroid body should be made.
Operations on thyroid body are performed under anesthesia (patient stays asleep and doesn’t feel pain). Some patients ask about local anesthesia for the operation, but, in fact, modern general anesthesia is pretty safe.
Duration of operation depends on the scope of surgical invasion. Average duration of operation is 60-100 minutes, although there can be longer operations, for instance, in case of lymph node damage, operation can last up to 3-4 hours.
After the operation, patient is taken to his ward. During the day after operation, it’s not recommended to stand up. If drainage has been installed, it will be removed the next day in bandaging room. While patient stays in clinic, daily bandages are made.
Average time spent in clinic is usually 2-3 days. After that, a patient can go home. Before that, it’s obligatory to consult with the doctor to discuss further treatment options.
Specific complications after thyroid surgery are damage of recurrent laryngeal nerves and hypoparathyroid gland disease. There are two recurrent laryngeal nerves – left and right. They lie behind thyroid body and go through throat joints to vocal cords. The main function of these nerves is sustaining of voice and ability to speak. The risk of nerve damage is less than 1%, if a patient is treated in special clinics. When treated in general surgical departments, a person has a higher risk of damage – from 5% to 13%. Right after the surgery, a person can experience changes in voice, but it’s a temporary condition. The risk of hypoparathyroid gland disease development is less than 1%. hypoparathyroid gland disease is characterized by lack of calcium in body – a patient can experience chillbumps in different body parts – face, legs, arms.
After thyroid operation, people can live normally, but replacement therapy and long-term rehabilitation are required. There’s one drawback – after the operation, a patient will need to use thyroxin medication till the end of his life. This is an analogue of thyroid hormone. It’s crucial to figure out the right dosage according to patient’s health condition and peculiarities.
The level of hormone is controlled once a month, and dosage is corrected annually. If surgical invasion took place before cancer, patient will also be administered radioactive iodine. It helps to prevent reoccurence and metastases.
After thyroid body removal, patients experience the following:
In most cases, if operation was successful, these symptoms will subside in 3 weeks. Only a small scar will be left.