A thyroidectomy is a surgical procedure to remove all or part of the thyroid gland through a small anterior neck crease incision. The thyroid gland is located in the front of the neck, and plays a crucial role in regulating metabolism, growth, and development through the production of thyroid hormones. It is closely related to the parathyroid glands, which regulate calcium, and recurrent laryngeal nerves, which contribute to volume and voice projection.

Thyroid cancer: To remove cancerous tumours or prevent the spread of cancer. The main thyroid cancers are follicular and papillary cancers. 

Non-cancerous thyroid nodules: To remove large or symptomatic nodules that cause difficulty swallowing, breathing, or speaking.

Diagnostic hemithyroidectomy: Some nodules cannot be diagnosed with biopsy/aspiration alone, and require further tissue in the form of a hemithyroidectomy for therapeutic and diagnostic purposes. 

Hyperthyroidism or Graves’ disease: To treat an overactive thyroid gland (hyperthyroidism) that does not respond to medication or other treatments.

Types of Thyroidectomy:

Total thyroidectomy: Removal of the entire thyroid gland.

Partial thyroidectomy (lobectomy): Removal of one lobe (half) of the thyroid gland.

Preparation: Before a thyroidectomy, you may be asked to complete certain preoperative tests, including :

blood tests, including thyroid function tests

imaging studies (such as ultrasound or CT scan), and 

aspiration [biopsy] of thyroid nodule/s

Procedure: Thyroidectomy is performed under general anaesthesia.  An incision is made in the front of the neck, usually along a natural skin crease, to access the thyroid gland. Depending on the type of thyroidectomy, either part or all of the thyroid gland is removed. The nearby parathyroid glands and recurrent laryngeal nerves are carefully preserved, with the aid of a nerve monitor, to minimize the risk of complications. 

Recovery: After surgery you will stay overnight in hospital with a small drain tube. The bed head will be kept at a 30 degree upright angle to reduce swelling, and pain medications may be prescribed to manage discomfort.  Depending on the extent of surgery and individual recovery, most patients can return to normal activities within a few weeks.

Although thyroidectomy is generally safe, complications can occur, including:

Bleeding: Risk of bleeding during or after surgery. This may warrant an early return to theatre to reduce swelling around the airway. 

Infection: Risk of wound infection.

Damage to adjacent structures: Risk of damage to nearby structures such as the parathyroid glands, recurrent laryngeal nerves (leading to voice changes), or the trachea (windpipe).

Hypothyroidism: Removal of the entire thyroid gland results in hypothyroidism, requiring lifelong thyroid hormone replacement therapy.

Scar formation: Formation of a visible scar on the neck following surgery, although this is minimised by following a natural neck crease over the thyroid gland.

Your neck wound has been closed with an absorbable vicryl suture and dressed with a water-proof comfeel dressing. You are fine to shower with the dressing on after 48 hours. The dressing will typically be removed by your surgeon at the 2 week follow up appointment. You can return to most normal activities on discharge, avoiding strenuous exercise and activities for 2 weeks. 

For patients undergoing total thyroidectomy, you will be commenced on a weight based dose of thyroxine, which needs to be taken everyday for the rest of your life in the morning on an empty stomach, 15 minutes prior to breakfast.