Thyroid/ Parathyroid
Parathyroid GlandParathyroid glands are 4 small glands the size of rice grain, located at the back of the thyroid gland in the neck. These glands control calcium level in your blood.Parathyroid Surgery IndicationsThe glands might become over-active (hyperparathyroidism) which results in increased calcium level. High calcium levels in your blood (hypercalcaemia) can result in feelings of: Lethargy Constipation Arrhythmia Kidney stones Fracture from osteoporosis, etc.In 80% of cases, this is due to a single over-active gland (parathyroid adenoma) and in >90% cases this single gland can be located before the operation. This means you will be suitable for a minimally invasive parathyroidectomy with a 1-2 cm incision. You will often only need to stay overnight in hospital for parathyroidectomy. All stiches are disolving to minimise scar.
In rarer occasion, it can also be due to cancer of the parathyroid gland (parathyroid carcinoma) which will involved more extensive surgery.
Thyroid GlandThe thyroid gland is a butterfly-shaped gland located in your neck anterior to the airway. It controls the metabolism of your body by producing thyroid hormone. The thyroid gland can form nodules (growth) in multinodular goitre. Thyroid nodule is a common findings on thyroid ultrasound and its management is dependant on the ultrasound appearance of the nodule (whether it has suspicious features), biopsy result and patient's symptoms.
Thyroid SurgeryHemithyroidectomyA hemithyroidectomy is the removal of half of thyroid gland. Indications for this operation include: Rapidly enlarging thyroid nodule Large thyroid nodule that causes obstructive symptoms or disfigurement Or in the case of atypical biopsy to confirm a diagnosis or excluding cancerThis operation can be done as a minimally invasive procedure with a small incision in the neck in selected case. Majority of patients will not need thyroid hormone replacement after hemithyroidectomy.
ThyroidectomyThyroidectomy (removal of the whole thyroid gland) is indicated in the following situations: Thyroid cancer Abnormal biopsy result Graves disease Large thyroid gland that causes obstruction of your airway or swallowing difficultyThis operation is often performed through an incision at the base of your neck. Dr Trinh will discuss with you in regard to placement of the scar to achieve best cosmetic result. Most scar is obvious first six months post op, however, this will fade with time. In small number of patients who is prone to thickened scar (keloid scar), the scar will be more obvious. You will need to be placed on thyroid hormone replacement medication after total thyroidectomy.
Neck dissection
Neck dissection means removing lymph nodes at different level in the neck, this procedure is carried out in selected cases of thyroid cancer.
Central neck dissection/ Level VI dissection: lymph nodes around thyroid are removed
Lateral neck dissection. Level II to V dissection: lymph nodes on the side of the neck are removed
Surgery RisksRisks and complications of routine thyroidectomy are rare and reportedly less than 2%.These include: Voice changes or voice loss from recurrent laryngeal nerves injury (temporary or permanent in less than 2%) Hypocalcaemia or low calcium level (temporary or permanent) Bleeding or wound complications
More information on Thyroid/ Parathyroid
Australian and New Zealand Endocrine Surgeons