Patient information leaflet

The thyroid gland is located in the lower part  of the front of the neck. It is divided into two halves on either side of the windpipe with a bridge of tissue joining them across the middle. The thyroid gland produces the hormone thyroxin which controls the rate at which the body's metabolism runs (it sets the idling speed for the body's engine). Sometimes half of the gland has to be removed (thyroid lobectomy) or the whole gland can be removed (total thyroidectomy).

What can I expect when I have the operation ?

You will normally be seen in the pre-admission clinic a few days before surgery to have a general medical examination. The operation will be performed under a general anaesthetic and normally requires 1 or 2 nights stay in hospital following the operation. There will be a thin scar approximately 3 inches in length across the lower part of the front of the neck. This is commonly closed with a stitch buried under the skin - it does not need to be removed. The scar usually heals very well and fades over 6-8 months.

You may return from theatre with 1 or 2 thin plastic tubes coming out of the skin below the wound. These are there to remove blood or fluid which may collect following the operation. They are usually removed within 24 hours. I do not routinely use drains and thus can do thyroid and parathyroid operation as day cases.

The operation is not especially painful and you can get out of bed and walk around shortly after surgery. Within 1-2 hours of the operation you should be able to eat and drink.

What problems can occur with thyroid surgery ?

Thyroid surgery is usually safe but there are specific problems that can occur. These are not common and are rarely permanent:

1. The nerves that supply the voice box are close to the thyroid gland and are sometimes affected by this types of surgery resulting in hoarseness. This usually recovers in a few days or weeks although the ability to sing very high notes may remain impaired.
2. Sometimes the small parathyroid glands can be affected during total thyroidectomy. These glands control the calcium levels in your body. It may be necessary for you to take calcium and vitamin D tablets to maintain normal calcium levels. A few patients will need to take these tablets permanently. Regular blood tests will be required to monitor this. This problem does not occur after thyroid lobectomy.
3. Bleeding inside the wound can cause the neck to swell and may rarely require an urgent operation to release it.
4. A wound infection can occasionally require antibiotics.

After the operation

If a total thyroidectomy has been performed, thyroid tablets (thyroxin) will be prescribed and need to be taken for life. They work exactly the same as natural hormone and require the occasional blood test to monitor activity. Occasionally, thyroxin tablets are required after a lobectomy if the remaining thyroid tissue fails to function normally. You will be given regular follow-up appointments and blood tests until it is clear that the thyroid hormone levels in your body are stable.

Keep the wound dry for 48 hours after which the dressing can be removed. If the wound becomes red and painful contact your GP for antibiotics.

Mr. H.S. Khaira  MD, FRCS.
Copyright © 2001  [H.S. Khaira]. All rights reserved.
Revised: October 24, 2004 .