Thyroid Surgery Questions

What is the purpose of the thyroid?    The thyroid gland regulates the bodies metabolism.   It is like the body's thermostat.   If it is under-functioning or "hypothyroid", then a patient will feel cold, tired, sluggish and have symptoms of dry hair, dry skin and constipation.  Over-functioning or "hyperthyroid" patients feel hot, sweaty, irritable or nervous, and have a rapid heart rate.  Blood tests can most accurately determine the status of the thyroid since these symptoms can also overlap with other conditions.

How is the thyroid evaluated?  Most evaluations start with a blood test to measure thyroid related hormones.   Ultrasound is a safe and gentle, non-invasive test using sound waves to look at the size and structure of the thyroid.   It is an accurate technique to measure and follow thyroid nodules over time.  Thyroid needle biopsy can be directed by feeling a nodule in the neck.  But, for greater accuracy on smaller nodules,  the ultrasound is used to visualize the needle in the center of the nodule to make sure an accurate specimen is obtained.   The Pathology doctor reads these slides and an summary is back in 2-3  days.   The Doctors of THE ENT GROUP will interpret and discuss the meaning of the biopsy with you,  and indicate if they feel surgery is necessary.  

What is a goiter?  A goiter is a general term for an enlarged thyroid.   It may be diffusely enlarged throughout the whole gland or enlarged by multiple nodules within the gland.  Goiters are common and if small are of no major significance if the thyroid blood tests are normal.   If the nodules are larger,  then your Doctor may recommend a needle biopsy to gain more information about the cells in one or more of the nodules.

What can a biopsy show?  This is the most important test to help determine if thyroid removal is necessary.  Biopsy can suggest a nodule is benign and can be observed with follow-up ultrasound.   However, it also can indicate that the cells are suspicious for a thyroid cancer and therefore require removal of the gland to obtain a complete sampling for analysis.  A suspicious biopsy does not indicate a cancer, but suggests statistically that a high percentage of lesions with this pattern of cells will be a cancer and therefore should be removed.

Can I live without my thyroid gland?    Absolutely.   Thyroid hormone replacement, by taking a single daily pill,  is very accurately regulated and a very common form of medical management by your Primary Care Physician.

Is the thyroid ever taken out for benign conditions?  Yes.   The benign goiter can sometimes get dramatically enlarged and appear as a mass in the lower neck.  In some cases it can compress the trachea causing difficulty breathing,  or the esophagus causing swallowing difficulty.  Usually a large gland is seen in the neck,  but occasionally the goiter is under the collar bone in the chest and is not recognized unless seen on a chest x-ray.