Tallahassee Ear, Nose and Throat has extensive experience with both thyroid and parathyroid surgery. There are a few different procedures that can be done to help alleviate issues that patients are experiencing with these particular endocrine glands.
If a thyroid nodule is large or has certain characteristics on ultrasound, we will likely need to conduct a fine needle aspiration (FNA) of the nodule. The FNA is a minor procedure that we can do in our clinic under ultrasound guidance. We numb the skin and area around the nodule, and then use a very small needle to collect cells to send to the pathologist to review under the microscope. If we are suspicious for a cancer, then your surgeon will talk to you about thyroid surgery.
The thyroid is sometimes removed if it is large enough to cause compression on the esophagus and discomfort when swallowing and breathing. It can also be removed if it is overactive and causing hyperthyroidism, or if thyroid cancer is diagnosed. In certain cases, only half the thyroid gland must be removed. Surgery is usually performed as an outpatient procedure, but in some cases you may need to stay overnight in the hospital. If you do have your entire thyroid gland removed, you will need to start on thyroid replacement hormone and take that pill once a day for the rest of your life. You may also need to take Calcium and/or vitamin D supplements temporarily.
Sometimes, one or more of the four parathyroid glands can become overactive, and cause your calcium levels to increase. This can cause problems with kidney stones and osteoporosis and has been associated with many symptoms and conditions to include stomach upset, chronic fatigue, bone pain, body aches, memory loss, poor concentration, depression, hypertension, and cardiac arrhythmias. Before we determine treatment, we will try to locate the abnormal parathyroid through ultrasound, nuclear medicine tests called Sestamibi scans, or a special kind of CT scan.
If you have a diagnosis of hyperparathyroidism, or too much parathyroid hormone, then surgery is typically recommended to remove any overactive glands. Surgery is usually done as an outpatient procedure, but in special cases you may need to stay overnight in the hospital. We sometimes give an injection of methylene blue to help localize the abnormal parathyroid during the surgery. If that happens, your urine may be temporarily green after the surgery. Do not be alarmed, as this is temporary. Please let your surgeon know if you take an anti-depressant medication, because these medicines can interact with the methylene blue.
The thyroid is one of the endocrine glands that makes hormones to regulate physiologic functions in your body, like metabolism. It is located in the middle of the lower neck, and wraps around the trachea, also known as the windpipe. Your thyroid has two lateral halves or “lobes” with a midline-connecting bit of tissue called the isthmus.Occasionally, we find nodules in the thyroid gland. A thyroid nodule is an abnormal lesion in that is different from the surrounding tissue. Nodules are quite common, especially in women. Ultrasound can detect thyroid nodules in over 20% of people. Thyroids with multiple or large nodules are sometimes referred to as a “goiter.” Nodules are important because approximately 10% can harbor a thyroid cancer.
The parathyroid is a group of glands that are closely involved, in terms of location and development, with the thyroid gland. There are four parathyroid glands, two on each side of the thyroid, and they control your calcium metabolism by way of parathyroid hormone. If the parathyroid glands become overactive, they can cause issues with calcium levels in the body.
In most situations, thyroid and parathyroid surgery is a very routine procedure and there are no problems. As with any surgical procedure, there is a possibility of severe bleeding or infection. However, this chance should be on the order of 1 in 100, or smaller. There is a small chance of injury to the main nerve, called the recurrent laryngeal nerve that controls vocal cord movement. This can cause hoarseness which usually improves dramatically with time or can be improved with other surgical procedures. Fortunately, permanent injury rarely occurs. Occasionally, a much smaller nerve, called the superior laryngeal nerve, can be injured. This happens slightly more frequently than the recurrent laryngeal nerve injury but is usually only important to singers. They would notice an inability to vocalize very high pitches.There is slightly more risk when the procedure is performed on both sides of the neck. In very rare cases, patients develop difficulty breathing and sometimes need a temporary tracheostomy. Having surgery on both sides can also lead to a low calcium level in the blood, but this can be treated medically and is usually temporary.
Please let your surgeon know if you take an anti-depressant medication, because these medicines can interact with methylene blue if it is used during your procedure. Do not take aspirin or ibuprofen-type products before your surgery unless approved by your surgeon.
In general, you will probably have a prescription for a pain medication for mild throat and neck pain. Use only Tylenol or the pain medication prescribed by your surgeon. Do not take aspirin or ibuprofen-type products after your surgery unless approved by your surgeon.
You will not have any diet restrictions and may resume light activity as tolerated. Please avoid any strenuous activities for 2 weeks. If you develop a tingling sensation or numbness around your lips or fingers, feel “weak” more than otherwise would be expected, or are having unexplained muscle cramps - please call and discuss this with your physician. These symptoms may occur even up to 5-7 days after surgery.
If you have any further questions or concerns that are not addressed here, please contact our office at any time. Our phone number is (850) 877-0101, and we are happy to help you learn more about thyroid and parathyroid procedures. Alternatively, you can send us a message with the contact us form and we will respond as soon as possible.