| Endocrine glands are the structures in the body which | | | | virtually invisible in time. The surgeon may leave a small |
| secrete hormones and the thyroid gland, anatomically | | | | drain tube in the neck to collect wound fluid and help |
| placed in the front of the neck, is responsible for the | | | | speed up the healing process, removing it on the first |
| production of thyroxine. Thyroxine is produced and | | | | or second day after operation. The stay in hospital will |
| passes into the blood and its function is to control the | | | | usually be two to four days. |
| metabolism with some control over the functioning of | | | | Patients should refrain from eating for six hours before |
| all the cells in the body. More thyroxine can be stored | | | | the operation and take clear fluids only up to two |
| and produced by the thyroid gland than can be used | | | | hours before the event. A venflon will be placed in the |
| by the body so if a partial thyroid removal is the | | | | arm and through this the anaesthetic is given to last for |
| necessary operation then the patient may not need to | | | | the hour or two the operation will take. Some surgeons |
| take thyroid replacement tablets. | | | | put stitches under the skin so removal is not |
| If the whole thyroid gland is excised then the patient | | | | necessary, others may use clips or stitches in the skin |
| will need to take tablets for thyroxine replacement | | | | which are taken out after a few days. Two to four |
| throughout their life. The size of four small rice grains, | | | | days is the typical hospital stay but this is dependent |
| the minute parathyroid glands adhere to the thyroid | | | | on how well people are, and on discharge they should |
| gland and secrete a hormone called parathyroid | | | | be collected by a relative. The level of pain after |
| hormone. Parathyroid hormone is closely involved in the | | | | thyroidectomy varies and typically patients have some |
| blood regulation of calcium concentrations, which | | | | around the neck. |
| promotes good health and the maintenance of a | | | | It is uncommon to get a wound infection and patients |
| healthy skeletal structure. During the thyroid removal | | | | should monitor the wound to check it does not |
| operation the surgeons take care not to affect the | | | | become sore and red, in which case antibiotics will be |
| parathyroid glands but the secretions of the glands can | | | | used. Rarely the wound needs to be re-explored to |
| be altered. | | | | release pus. There is a one in fifty chance of bleeding |
| Thyroidectomy is the removal of the thyroid gland, | | | | occurring into the wound and the hematoma has to be |
| either a total thyroidectomy or partial removal, called a | | | | explored and removed in rare cases. It is common to |
| sub-total thyroidectomy, hemithyroidectomy or | | | | have wound swelling and bruising which is caused by |
| lobectomy. There are several reasons for removing all | | | | the bleeding under the wound and later by scarring. |
| or part of the thyroid gland. Overactivity of the thyroid | | | | Patients will have a vocal chord check before surgery |
| gland is the main reason, known as hyperthyroidism or | | | | and the surgeon will discuss the specific problems of |
| Graves' disease or when goitre occurs with an | | | | operating so close to the voice box and its associated |
| enlarged thyroid. Goiters are removed either because | | | | nerves. Bruising of the nerves during surgery may stop |
| they are causing pressure on the windpipe or gullet, | | | | them working properly and as these nerves control |
| are causing breathing or swallowing problems or they | | | | the movements of the vocal chords if they are |
| may look unsightly. | | | | damaged this can cause hoarseness and weakness in |
| Thyroidectomy will be carried out under a general | | | | the voice. The voice should recover over a period of a |
| anaesthetic which means the patient is unconscious | | | | few weeks or months but occasionally a nerve will be |
| during the whole operation. An incision will be made in | | | | permanently damaged but this is rare. Injury to both |
| the neck, often made in the natural skin crease just | | | | nerves is very uncommon and very serious as the |
| above the top of the breastbone and always made | | | | voice is lost and a tracheotomy tube is placed in the |
| symmetrically. This helps the incision to heal, leaving a | | | | windpipe to allow breathing to occur. |
| scar which is usually inconspicuous and may become | | | | |