Diseases of the thyroid gland are very common, affecting millions of people in the globe, but the most common thyroid problems are: An overactive gland, called hyperthyroidism especially Graves disease, toxic adenoma or toxic nodular goiter.

Background

Thyroid enlargement due to over activity (as in Graves’ disease) or from under-activity (as in hypothyroidism).

An enlarged thyroid gland is often called a goiter.

Patients with a family history of thyroid cancer or who had radiation therapy to the head or neck as children for acne, adenoids, or other reasons are more prone to developing thyroid malignancy.

How is a Thyroid disorder Diagnosis Made?

The diagnosis of a thyroid function abnormality or a thyroid mass is made by taking a medical history and a physical examination.

In addition, blood tests and imaging studies or fine-needle aspiration may be required.

According to Dr Bruce W. Peters, ENT-Otolaryngologist in Toms River, New Jersey, as part of the exam, doctors will examine your neck and may ask you to lift up your chin to make your thyroid gland more prominent.

You may also be asked to swallow during the examination, which helps to feel the thyroid and any mass in it.

Some other tests doctors may order include: Evaluation of the larynx/vocal cords with an Eber optic telescope, An ultrasound examination of your neck and thyroid Blood tests of thyroid function, A nuclear thyroid scan, ultrasound guided fine-needle aspiration biopsy and a CT or MRI scan 

What are Thyroid Nodules?

Thyroid nodules are common, occurring in 15-65 percent of people of all ages. They occur in both women and men, but are especially common in women (50 per cent of women or older have had a thyroid nodule).

Usually patients and their physicians first notice thyroid nodules during a routine physical exam of the neck area. Sometimes they are found incidentally during a radiographic evaluation of the neck (such as a CT scan, X-ray, MRI or Ultrasound).

 Although the vast majority of thyroid nodules are benign, the physician should evaluate a significant thyroid nodule, as approximately 5-10 percent of thyroid nodules are cancerous.

In general, a thyroid nodule is considered “significant” if it is one centimeter or larger and/or presents concerning features on ultrasound.

What is Thyroid Surgery?

There is no medical treatment for thyroid nodules.

 If a decision is made that the thyroid nodule needs to be removed, surgical treatment is recommended.

 Nodules that are suspicious or cancerous on biopsy require surgical removal.

Large nodules are often removed for a number of reasons. Benign large thyroid nodules may cause pressure symptoms in the throat or cause difficulty swallowing.

Thyroid nodules that produce excess thyroid hormone may also need to be removed. Some thyroid nodules are large enough that standard diagnostic approaches prevent accurate assessment of the possibility of cancer and, therefore, need to be surgically removed.

Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital and general anesthesia is usually required.

Typically, the operation removes the lobe of the thyroid gland containing the suspicious nodule or lump. A frozen section (immediate microscopic reading) may be used to determine if the rest of the thyroid gland should be removed during the same surgery.

Based on the result of the frozen section, the decision will be made in the operating room if removal of any remaining thyroid tissue is necessary. These options will be discussed with you preoperatively by the doctor.

According to Dr Peters, as an alternative, he may choose to remove only one lobe and wait for the final pathology report before deciding, if the remaining lobe needs to be removed.

If a malignancy is identified in this way, he may recommend that the remaining lobe of the thyroid be removed at a second procedure.

What happens after Thyroid Surgery?

The surgery usually takes two to three hours, and most patients were watched carefully in the hospital overnight. Its pain is often minimal, and will take four to seven days off.

Amadu Kamil Sanah, Toms River, New Jersey, USA