Dr Erick Fuentes - Breast and General Surgeon

Email Dr Erick Fuentes  info@drerickfuentes.com.au
Phone Dr. Erick Fuentes  +61 2 8203 1359
Fax Dr Erick Fuentes +61 2 9475 5442

General Surgery

Thyroid & General Surgery

Thyroid and General Surgery

What is a thyroid gland?

The thyroid is a small and butterfly shaped. Normally measuring about 5 cm in length, it’s located in the front of the neck below the larynx, or Adam’s apple. It has two lobes, one on each side of the trachea or windpipe. The lobes are joined by a narrow band of tissue called the isthmus.

The thyroid gland produces, stores and regulates hormones (thyroxin and triiodothyronine) that effect just about every organ in your body, controlling metabolism by telling cells how much energy to use. These hormones also influence brain development, breathing and nervous systems, body temperature, muscle strength, skin dryness, menstruation, weight gain/loss and cholesterol levels. Another function of the thyroid gland is to regulate the amount of calcium in your blood and bones.

A healthy thyroid will maintain the right level of hormones needed to keep the body’s metabolism functioning at a just the right rate.

The level of thyroid hormones in the bloodstream is monitored and controlled by the pituitary gland. When the pituitary gland, senses either a lack of thyroid hormones or a high level of thyroid hormones, it will adjust its own hormone (TSH) which acts as a messenger, to tell the thyroid what it needs to do.

What is thyroid disease?

Thyroid disease is very common and treatable. When the thyroid produces too much hormone, the body uses energy faster than it should. This condition is called hyperthyroidism. When the thyroid doesn’t produce enough hormone, the body uses energy slower than it should. This condition is called hypothyroidism. There are many different reasons why either of these conditions might develop.

Hypothyroidism – insufficient hormone

  • Thyroiditis is an inflammation of the thyroid gland. This can lower the amount of hormones produced.
  • Hashimoto’s thyroiditis  is a painless disease of the immune system that is hereditary
  • Postpartum thyroiditis  occurs in 5% to 9% of women after giving birth. It is usually a temporary condition.
  • Iodine deficiency  is a problem affecting approximately 100 million people around the world. Iodine is used by the thyroid to produce hormones.
  • A non-functioning thyroid gland  affects one in 4,000 newborns. If the problem isn’t corrected, the child will be physically and mentally damaged. All newborns are given a screening blood test in the hospital to evaluate thyroid function.
  • It would be wise to get your hormone levels checked if you experience the following symptoms, a straightforward blood test will show up any abnormality:
    • Unusual fatigue
    • Frequent, heavy menstrual periods
    • Forgetfulness
    • Unexplained weight gain
    • Dry, coarse skin and hair
    • Hoarse voice
    • Intolerance to cold

Hyperthyroidism – Too Much Hormone

  • If you have Graves’ disease, the entire thyroid gland might be overactive and produce too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland).
  • Nodules might be overactive within the thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while several nodules are called a toxic multi-nodular goiter.
  • Thyroiditis, a disorder that can be painful or painless, can also release hormones that were stored in the thyroid gland causing hyperthyroidism for a few weeks or months. The painless variety occurs most frequently in women after childbirth.
  • Excessive iodine is found in drugs such as Amiodarone, Lugol’s solution (iodine), and some cough syrups, and might cause the thyroid to produce either too much or too little hormone in some individuals. 

Symptoms for hyperthyroidism:

  • Unusual irritability/nervousness
  • Muscle weakness/tremors
  • Infrequent, scant menstrual periods
  • Weight loss
  • Sleep disturbances
  • Enlarged thyroid gland
  • Vision problems or eye irritation
  • Heat sensitivity

When is Thyroid Surgery Needed?

I would generally recommend surgery for the following reasons:

  • To check whether a nodule on the gland is cancerous or benign. Thyroid nodules are usually benign. A sample of tissue can be removed using a fine needle biopsy so that cells can be examined under a microscope.
  • If the thyroid nodule or the whole gland is enlarged and causing bothersome or dangerous symptoms, such as trouble swallowing, difficulty breathing, or changes to the voice. 
  • To check whether a nodule on the gland is cancerous or benign. Thyroid nodules are usually benign. A sample of tissue can be removed using a fine needle biopsy so that cells can be examined under a microscope.
  • If the thyroid is growing into the chest cavity below.
  • The thyroid is overactive (hyperthyroidism) and not responding to other medical treatments.  Graves’ disease or overactivity in one or more nodules can cause hyperthyroidism.

What types of operations might be suggested?

There are various types of thyroid operations. They include:

  • Total thyroidectomy – removal of the whole thyroid.
  • Bilateral subtotal thyroidectomy – removal of most of the thyroid leaving part of both lobes behind.
  • Hemithyroidectomy – removal of half the thyroid.
  • Excision of thyroid nodule – removal of a lump from the thyroid.
  • Isthmectomy – removal of the bridge of thyroid tissue linking the two thyroid lobes.

If a total thyroidectomy is needed, you can lead a perfectly normally, but you’ll need to take thyroxine tablets for the rest of your life. If less than a total thyroidectomy is performed, you will generally not need to take thyroxine although around 15% of people still require some thyroxine supplementation after just a hemithyroidectomy.

Recovery from thyroid surgery

Most people can return to their regular activities the day after thyroid removal surgery. Limit strenuous physical activities or sports for two weeks, after surgery.

You will likely have a sore throat for a few days. Over-the-counter pain relievers, such as paracetamol or ibuprofen, are usually sufficient pain relief.

After surgery, I’ll monitor your thyroid hormone and calcium levels to check for hypothyroidism or hypoparathyroidism. It is important that you tell me if you experience hoarseness in your voice or have difficulty breathing. Also let me know if there is sudden swelling in your neck after you have gone home as this may be a sign of a delayed bleed.

What are the risks and complications of thyroid surgery

Most surgery nowadays is safe however any operation has general risks including reactions to the anaesthetic, chest infections, blood clots, heart and circulation problems, and wound infection.

There are specific risks associated with thyroid surgery as follows:

  • Post-operative bleeding may cause swelling in the throat and difficulty breathing due to pressure on the windpipe. It is usually fixed by a further operation to remove the blood clot
  • Injury to the laryngeal nerves may cause hoarseness of the voice. This is usually temporary, but may be permanent in up to 1 to 2% of cases. It may improve with speech therapy or further surgery to the vocal cords. If you are a singer or public speaker, any surgery to the thyroid may cause subtle long-term changes to your performing voice.
  • If a total thyroidectomy is performed, injury to the parathyroid glands may cause the calcium level in the blood to drop. It is treated with calcium and vitamin D tablets and usually comes good in a few weeks, although up to 1 to 2% of cases will need lifelong calcium supplements.
  • A keloid, or overgrowth of scar tissue, may form in any surgical scar. It will result in a tender, pink raised scar but may able to be treated with silicone gel tape or steroid injections.

For all appointments and enquiries, please call +61 2 8203 1359 or email info@drerickfuentes.com.au

Or contact us online using this form:

Request an Appointment Or Send a Message

Wise Medical

Level 1
11 Khartoum Road
Macquarie Park

Strathfield Private Hospital

3 Everton Rd,
Strathfield NSW 2135
Hours: 9am - 5pm