Common Conditions

Thyroid: Operation

The anaesthetic is given through a needle in the back of your hand and you will fall asleep within seconds. The neck area is cleaned with an antiseptic and the site draped with sterile towels. A curved horizontal incision in the lower central portion of the neck is made which is designed to fit with the skin creases. One or both lobes of the thyroid gland is removed after careful dissection which involves the recognition and preservation of the external branch of the superior laryngeal nerve, the recurrent laryngeal nerve, the cutaneous nerves of the neck and the parathyroid glands. The laryngeal nerves affect the vocal cords and the parathyroid glands are concerned with the control of calcium in the blood and tissues. In some situations, only a portion or a half of the thyroid gland requires removal (lobectomy) and this is particularly true of benign conditions.

The thyroid is made up of two symmetrical lobes, one on each side of the windpipe, just below the larynx. Where there is enlargement of both lobes, malignancy, a very bulky problem, or in situations where almost all the tissue needs to be removed because it is very over-active, both lobes may be completely removed (total thyroidectomy). If the operation is being done for cancer, the surgeon will make a search for any spread to the lymph nodes in the neck. If they are found to be involved, more tissue may need to be removed. The thyroidectomy incision may have to be extended along the lower neck or at the side of the neck in order to enlarge the exposure for such an operation.

At the end of the operation, the incision is closed with a suture and a couple of small tubes (drains) may be left in the wound for a day or so to drain any tissue fluid. The entire area is treated with a long acting local anaesthetic which provides excellent pain relief for the first few hours. The drains and sutures are usually removed a few days later and the wound supported with adhesive paper. The neck can be gently washed soon after the operation. Some swelling and bruising under the scar is quite common at first and the upper part of the incision may swell over the lower part, causing a pouting distortion for a few weeks. However, this will settle down over time to leave a scar which is barely visible after several months.