Thyroidectomy 218767 217421524 2008-06-05T23:24:02Z SmackBot 433328 Date the maintenance tags or general fixes {{Interventions infobox | Name = Thyroidectomy | Image = | Caption = | ICD10 = | ICD9 = 06.3 | ICD9_mult = {{ICD9proc|06.5}} | MeshID = D013965 | OtherCodes = | }} A '''thyroidectomy''' involves the [[surgery|surgical]] removal of all or part of the [[thyroid gland]]. Surgeons often perform a thyroidectomy when a patient has thyroid [[cancer]] or some other condition of the thyroid [[gland]] (such as [[hyperthyroidism]]). Other indications for surgery include cosmetic (very enlarged thyroid), or symptomatic obstruction (causing difficulties in swallowing or breathing). The thyroid produces several [[hormone]]s, such as [[thyroxine]] (T4), [[triiodothyronine]] (T3) and [[calcitonin]]. After the removal of a thyroid patients usually take prescribed oral synthetic thyroid hormones to prevent the most serious manifestations of the resultant [[hypothyroidism]]. Less extreme variants of thyroidectomy include: * "hemithyroidectomy" (or "unilateral lobectomy") -- removing only half of the thyroid * "isthmectomy" -- removing the band of tissue (or [[isthmus]]) connecting the two lobes of the thyroid A "thyroidectomy" should not be confused with a "[[thyroidotomy]]" ("[[thyrotomy]]"), which is a ''cutting into'' (-otomy) the thyroid, not a ''removal'' (-ectomy) of it. A thyroidotomy can be performed to get access for a [[median laryngotomy]], or to perform a [[biopsy]]. (Although technically a biopsy involves removing some tissue, it is more frequently categorized as an -otomy than an -ectomy because the volume of tissue removed is minuscule.) == Indications == Malignancy <br />Cosmetic reasons <br />[[Goitre]] which is untreatable by medical methods <br />Severe [[hyperthyroidism]] refractory to conservative treatment <br />Orbitopathy in [[Graves' disease]] <br />Removal and evaluation of a nodule whose [[FNAB]] results are unclear {{Expand-section|date=June 2008}} == Steps == Main steps of Thyroidectomy: # [[Exposure]] - horizontal neck incision, +/- raising of flaps, +/- division of strap muscles # [[Identification of essential structures]] - Recurrent and ext. branch of superior laryngeal nerve, parathyroid glands # [[Devascularization]] # [[Resection]] # [[Exploration of other pathology]] - e.g. contralateral lobe, lymph nodes # [[Closure]] {{Expand-section|date=June 2008}} == Complications == #[[Hypothyroidism]] in up to 50% of patients after ten years #[[Laryngeal nerve]] injury in about 1% of patients, in particular the [[recurrent laryngeal nerve]]: Unilateral damage results in a hoarse voice. Bilateral damage presents as laryngeal obstruction on removal of the tracheal tube and is a surgical emergency: an emergency [[tracheostomy]] must be performed. Recurrent Laryngeal nerve injury may occur during the ligature of the inferior thyroid artery. # [[Hypoparathyroidism]] temporary in many patients, but permanent in about 1-4% of patients # [[Haemorrhage]]/[[Hematoma]] # [[Thyrotoxic crisis]] # [[Surgical scar/keloid]] # [[Infection]] # [[Anesthetic complications]] ==External links== * [http://health.yahoo.com/health/encyclopedia/001159/0.html Yahoo] * [http://www.thyroidectomy.com Minimally Invasive Endoscopic Video Assisted Thyroid & Parathyroid Removal Surgery] * [http://gallery.hd.org/_c/medicine/_more2006/_more08/thyroidectomy-total-scar-on-neck-of-adult-male-patient-after-thyroid-gland-surgically-completely-removed-to-eliminate-small-cancerous-nodule-1-ANON.jpg.html Early postoperative scar images] {{Endocrine system intervention}} [[Category:Surgical procedures]] [[Category:Shoulder surgery]] {{treatment-stub}} {{Link FA|de}} [[de:Thyreoidektomie]] [[fr:Thyroïdectomie]] [[it:Tiroidectomia]] [[pt:Tiroidectomia]]