The thyroid gland is a butterfly-shaped organ that secretes thyroid hormones (T3, T4) into the body and is located in the midline of the neck in front of and on both sides of the trachea. Hypothyroidism occurs as a result of the gland secreting less hormone, and hyperthyroidism, known as toxic goiter among the people, occurs as a result of excessive secretion. A mass called nodule and associated cancers may develop in it. Apart from these, there are inflammatory diseases called thyroiditis of autoimmune origin (Hashimoto’s thyroiditis, Basedow Graves) or microbial origin.D
- Inflammatory and autoimmune diseases are treated with drugs, while toxic goiters that do not respond to treatment, large cancer-suspected nodules and cancer-diagnosed nodules are treated surgically.
- The most important reason for the formation of nodules is iodine deficiency in water.
- Nodules are basically evaluated with neck ultrasonography and fine needle aspiration biopsy (FNAB).
- In the presence of nodules diagnosed as cancer or suspected, surgical treatment should be performed.
Depending on the location and size of the tumor and nodules, patients are performed either bilateral total thyroidectomy or unilateral total thyroidectomy. If the cancer spreads to the lymph nodes in the neck region, neck dissection operations should be performed in order to clean the glands in the neck.
The thyroid gland is an important surgery because of the adjacent vocal nerves and the presence of 4 lentil-sized parathyroid glands that manage bone metabolism. In case of injury to the vocal nerve, permanent hoarseness and shortness of breath develop. In order to prevent these problems, it is necessary to use a monitoring device that shows the nerves as well as a meticulous surgery. Surgical experience is critical at this stage.
Surgical treatment can be done open and closed, namely laparoscopic surgery (TOETVA). In the closed method, thyroid surgery is performed by entering through the mouth. The purpose of this method is not to leave a visible scar on the neck. Today, cosmetic surgeries are preferred by patients.
What awaits patients after goiter surgery?
Patients are definitely prepared for surgery, including thyroid hormone tests. Hormone levels must be normal for surgery. The surgery takes about 2 hours. Nerve monitoring must be done in the surgery. If everything goes well, the patients who are hospitalized for 1 day after the operation are discharged by removing their drains.
After about a week, the pathology result is evaluated.
Patients diagnosed with cancer are referred to Nuclear Medicine centers for Radioactive Iodine therapy (Atom therapy).
Thyroid hormone medication is started and followed-up for those who come clean as a result of pathology.
Parathyroid gland diseases and surgery
They are glands that secrete parathyroid hormone (PTH) as large as 4 lentils, two on the right and two on the left, on the thyroid gland. They regulate the body’s calcium metabolism. It is the hormone that has the most important role in bone formation and destruction.
These glands must be protected during thyroid surgery. In addition, there are adenomas of the parathyroid gland that cause enlargement and excess hormone secretion, and their treatment is surgical. Surgical removal of structures called adenomas provides definitive treatment.
The treatment is done by open surgery or closed laparoscopic method. Removing the correct gland and protecting the nerves is critical in surgery.
