Health Library

​​What is Thyroidectomy?

Thyroidectomy refers to the surgical removal of the thyroid gland.

Types of Thyroidectomy

1. Hemithyroidectomy
   Removal of either the right or left thyroid lobe with the isthmus (central part of the thyroid gland)
2. Total Thyroidectomy
   Removal of the whole thyroid gland. Patients will need to take lifelong thyroid hormone replacement after the surgery.

When is Thyroidectomy Needed?

1. Thyroid cancer
2. Swelling in the neck (large goitres) causing difficulty in breathing, speaking and swallowing
3. Refractory hyperthyroidism despite medical treatment (e.g. Graves disease)
4. Surgical restoration or enhancement of physical appearance

How is the Surgery Performed?

• Performed under general anaesthesia
• A recurrent laryngeal nerve monitor may be used
• Two types of surgical methods:
  1. Conventional open approach
  2. Endoscopic / robotic approach
• Duration of surgery ranges from two to four hours, depending on the procedure and approach

Preparation for Surgery

• You will undergo anaesthesia review and blood tests before the surgery to determine your fitness for surgery.
• You may need to stop aspirin and other blood thinning medications for seven to ten days before the surgery to reduce the risk of bleeding. If you have to continue them for other medical reasons, please consult your surgeon.
• Your surgery may be postponed if you develop a fever, cold, flu, sore throat or any other illnesses 24 to 48 hours before the day of surgery. Please inform your doctor if you feel unwell.

What to Expect Immediately After the Surgery?

• Stitches and numbness around the wound site
• A neck drain may be placed around the wound site.
• You will be able to eat, drink and talk after the surgery.

Possible Risks of Surgery   

1. Voice Changes
   After surgery, there may be temporary weakness of the nerves that supply the voice box, resulting in a hoarse, weak voice or swallowing issues. If the nerves are injured, your airway and breathing may be affected, however this rarely occurs. Risk of permanent damage to these nerves is about 1%.
2. Low Calcium Levels
   In a total thyroidectomy, injury or damage to the parathyroid glands will cause low calcium levels. You may experience symptoms like numbness or tingling in the finger or lips. This is usually temporary, as the parathyroid glands eventually recover. Calcium and Vitamin D replacement will be prescribed.
3. Bleeding
   There is a risk of bleeding from the wound site which can lead to swelling and blockage of the airway. Drains may be placed during surgery to facilitate drainage of excess fluid and prevent formation of blood clots.   
4. Neck Numbness
   Numbness around the wound site is common after surgery. This improves as the wound heals.
5. Wound Scarring
   The chance of scar or keloid formation is less than 1%.
6. Hypothyroidism
   Following surgery, the remaining thyroid gland may not produce enough thyroid hormone, which may cause you to feel lethargic and weak. You will require life-long thyroid hormone replacement in such cases.

Home Care After Surgery

1. Activity
   You can resume normal activities as your condition improves.       
2. Diet
   There are no restrictions on your diet. However, soft diet is advised if you have throat discomfort.
3. Medications
   Take thyroid hormone replacement and/or calcium supplements as prescribed by your doctor.        
4. Wound Care
   Keep the exposed wound clean and dry. Check your wound daily for:
   
• Redness
• Swelling
• Discharge (blood, pus)
• Severe pain
If you develop any of the above, please inform the ENT clinic or surgeon immediately.
5. Care of Drain
   If you are discharged with a neck drain, keep the drain well secured and anchor it at waist level. Remember to measure and record the amount of drainage daily.
6. Follow-up Appointment
   Please keep to your appointment date and timing for review of wound and removal of stitches or drain.