The thyroid gland has butterfly shape and is seated in front of the neck. Enlargement of this gland is sometimes called a goitre. There are many different types of thyroid disorders. The gland may not work properly being overactive (hyperthyroidism) or underactive (hypothyroidism) affecting the level of thyroid hormones in the blood. Nodules or growths may also develop in the gland. The term thyroid nodule refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. The vast majority of thyroid nodules are benign (noncancerous), however a small proportion do contain thyroid cancer. In order to diagnose and treat thyroid cancer at the earliest stage, most thyroid nodules need some type of evaluation. Nodules may become very large and compress important structures in the neck. They may also grow down into the chest, this makes them more difficult to assess and remove.
Thyroid surgery is an important tool in the treatment of some of these problems.
Your doctor may recommend that you consider thyroid surgery for 4 main reasons:
- You have a nodule that might be thyroid cancer.
- You have a diagnosis of thyroid cancer.
- You have a nodule or goiter that is causing local symptoms – compression of the trachea, difficulty swallowing or a visible or unsightly mass.
- You have a nodule or goiter that is causing symptoms due to the production and release of excess thyroid hormone – either a toxic nodule, a toxic multinodular goiter or Graves’ disease.
The extent of your thyroid surgery may be classified as a partial thyroidectomy or a total thyroidectomy. Removal of part of the thyroid can be classified as:
- A hemi-thyroidectomy or thyroid lobectomy – where one lobe (one half) of the thyroid is removed;
- An isthmusectomy – removal of just the bridge of thyroid tissue between the two lobes; used specifically for small tumors that are located in the isthmus.
- A total or near-total thyroidectomy is removal of all or most of the thyroid tissue.
The recommendation as to the extent of thyroid surgery will be determined by the reason for the surgery. The extent of surgery is both a complex medical decision as well as a complex personal decision and should be made in conjunction with your surgeon.