Your thyroid gland is an endocrine glands that makes hormones to regulate physiological functions in your body, like metabolism (heart rate, sweating, energy consumed). The thyroid gland is located in the middle of the lower neck, below the larynx (voice box) and wraps around the front half of the trachea (windpipe). It is shaped like a butterfly, just above the collarbones, having two halves (lobes) joined by a small tissue bar (isthmus.). You can't always feel a normal thyroid gland.
What is a thyroid disorder?
There are many different types of thyroid diseases. Diseases of the thyroid gland are very common, affecting millions of Americans. The most common thyroid problems are overactive glands (hyperthyroidism), underactive glands (hypothyroidism), thyroid enlargement (goiter), thyroid nodules and thyroid cancers. Ear, nose and throat (ENT) specialists perform surgery to treat thyroid nodules, thyroid enlargement and thyroid cancer.
Goiters (thyroid enlargement):
If you experience a goiter, your doctor will propose a treatment plan based on the examination and your test results. He/she may recommend an ultrasound to determine the size of the gland and any nodules, a needle biopsy (FNA) to sample some of the nodules, or thyroid surgery.
Thyroid surgery may be recommended if the trachea (windpipe) or esophagus are compressed because one or both lobes are very large, or if the needle biopsy is reported as indeterminate, suspicious or suggestive of cancer.
Thyroid nodules are very common. A nodule is an area of abnormal growth within the thyroid gland. Some people have a single nodule while others have multiple nodules within the gland. Thyroid nodules, which are particularly common in women, can be tiny to very large in size. Most thyroid nodules are non-cancerous, do not cause symptoms and do not need any treatment. However, in some cases the nodule may need further evaluation or treatment.
Thyroid surgery may be recommended if the nodule (s) are found to contain cancer or suspicious of cancer.
How are thyroid nodules evaluated?
The evaluation of a thyroid nodule typically consists of a thyroid ultrasound, and possibly a fine-needle aspiration biopsy (FNA) of the nodule. Laboratory tests measure the overall function of the thyroid gland to determine if it is hyper (too high) or hypo (too low) active. A thyroid ultrasound can help identify the size and location of the nodule as well as whether it is solid or filled with fluid (cystic).
The fine-needle aspiration is a procedure where a small needle is inserted into the nodule and some of the cells from the thyroid nodule are pulled back into a syringe to be evaluated under the microscope by a pathologist.
What is thyroid surgery?
Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital, and general anesthesia is usually required. Typically, the operation removes the lobe of the thyroid gland containing the lump and possibly the isthmus. A frozen section (immediate microscopic reading) may be used to determine if the rest of the thyroid gland should be removed during the same surgery. Sometimes, based on the result of the frozen section, the surgeon may decide not to remove the entire thyroid gland, and/or other tissue in the neck. This decision is usually made in the operating room by the surgeon, based on findings at the time of surgery. Your surgeon will discuss these options with you preoperatively.
As an alternative, your surgeon may choose to remove only one lobe and await the final pathology report before deciding if the remaining lobe needs to be removed. There also may be times when the definite microscopic answer cannot be determined until several days after surgery. If a malignancy is identified in this way, your surgeon may recommend that the remaining lobe of the thyroid be removed at a second procedure. If you have specific questions about thyroid surgery, ask your otolaryngologist to answer them in detail.