Partial Thyroid Surgery
Partial thyroidectomy consists in removing a thyroid lobe and isthmus. It is taken into account if the volume of this lobe or nodule is important, or threatens to compress the adjacent anatomical structures, or in case of suspicion of cancer.
Surgery procedure and post-surgery effects
Ablation of the thyroid gland is performed in the surgical unit, under general anaesthesia, by a cervical incision of about 5 cm at the base of the neck.
The neck is placed in hyperextension, to raise the thyroid gland, which is behind the sternum. This can cause postoperative pain. In case of cancer, it is necessary to extend the surgery to the other thyroid lobe and to cervical ganglionic chains, which lengthens both the skin incision and the duration of the procedure.
The patient is hospitalized the day before or the morning of the surgery.
In case of lobectomy (partial excision of the gland) hospitalization is about 24 hours and in some cases this intervention can even be done in ambulatory surgery. In the postoperative phase, only analgesic treatment will be prescribed. The head and neck surgeon will visit his patient again after one week, in order to check the local evolution, mobility of the vocal cords and to communicate to the patient the histological study of the surgical sample.
Three weeks later, a blood test ensures the sufficient functioning of the remaining lobe, which rules out the need to take hormone replacement therapy.
Complications can occur during partial thyroidectomy. If one of the two lower laryngeal nerves (also called recurrent nerves, see diagrams below), located on each side of the trachea behind each of the thyroid lobes, is injured, a voice problem may occur (dysphonia) because each nerve moves one of the two vocal cords.
Hematoma (effusion of blood) can also occur, that can compress the trachea and impose emergency recovery in the surgical unit.
Thyroidectomy is, therefore, a delicate surgical operation which must be performed by an experienced surgeon. The parathyroid glands and recurrent nerves should be systematically located and dissected carefully, in order to increase their chances of being preserved.
A suction drain could be left for a few hours or 24 hours. The cutaneous incision is sutured in two planes, by resorbable thread to whipstitch the dermis, which gives an excellent aesthetic result. In most cases, the scar is barely visible after a few months. The scar must be protected from direct exposure to the sun for a year.
Coverage of thyroidectomy by social security
This surgery is covered by social security, but your head and neck ENT surgeon may request an additional fee according to his degree of experience.
Dr. Stéphane Hervé is an ENT specialist and head and neck surgeon, who graduated from some of the best universities in France. In the thyroid surgery, he combines the precision of the surgical technique, which allows a discreet and aesthetic scar with the technological innovation of the NIM-response 3.0 intraoperative nervous tracking system by Medtronic, which decreases the risk of nerve damage and insures good health at the end of the surgery.