Thyroidectomy

There are two types of thyroidectomy surgery:

• Partial thyroidectomy: The surgeon takes out part of the thyroid gland.
• Total thyroidectomy: The surgeon removes the entire gland.

• A thyroidectomy can treat an overactive thyroid or other thyroid problem that is having an impact on your child’s life and health.
• Thyroid removal can help doctors diagnose a lump or nodule on the thyroid.
• If your child has been diagnosed with thyroid cancer, removing the gland can prevent spread of the cancer. (Thyroid cancer is typically slow growing and very treatable with thyroidectomy and medicine.)

Risks of thyroidectomy include:

• Voice changes
• Low calcium levels (temporary or permanent)
• Bleeding
• Infection

Consulting a board-certified otolaryngologist (ear, nose and throat specialist) and multi-specialty teams that specialize in children’s care minimizes risks. 

• The doctor will discuss your child’s medical history and symptoms. 
• You may be asked if you know of any thyroid or calcium level problems among the child’s family members.
• If your child has been diagnosed with thyroid cancer, the doctor will want to know what, if any, treatments your child has had.
• After a physical examination of your child’s neck, the doctor may want to perform a thyroid ultrasound for a better look at the gland. 
• A test to see how well your child’s thyroid absorbs iodine may help the doctor plan surgery.
• Another test called a fine needle aspiration can take a sample of cells from the thyroid for a pathologist to examine under a microscope. 

When the surgery is scheduled, the doctor will outline the approach, such as what kind of thyroidectomy is most appropriate and what you and your child can expect. The doctor may prescribe medicine to balance your child’s thyroid hormone levels before surgery.

The doctor will remove all or part of your child’s thyroid gland in a hospital operating room with your child asleep under general anesthesia. 

Thyroidectomy is complex surgery because the thyroid gland is so close to the parathyroid glands, as well as important nerves and blood vessels. Removing the thyroid takes great care, and so the procedure can last several hours.

• Once your child is asleep, the doctor makes an opening in the skin in front of your child’s neck.
• The doctor moves the skin and neck muscles aside to get to the thyroid gland.
• The doctor carefully removes a section of the thyroid or the entire gland.

• The doctor uses stitches (sutures) to close the opening.
• There may be drains temporarily placed in the surgical area.
• The doctors will check your child’s calcium levels to make sure they are not too low. If that happens, your child will receive calcium and may need to stay overnight at the hospital.
• Your child may need to take thyroid hormone pills.
• The scar on your child’s neck fades over time.

If the thyroidectomy is to diagnose a mass or growth on the thyroid, the surgeon will send a section of the tissue to a pathologist. The pathologist examines the cells of the thyroid under a microscope to look for signs of disease. Pathology reports can take a week or two to come back from the laboratory.