Monday Medical: Tackling a thyroidectomy

Susan Cunningham
Monday Medical

The thyroid is a small, butterfly-shaped gland that sits at the base of the neck and does a very important job: It uses iodine from the food we eat to make thyroid hormones, which help control functions such as metabolism, heart rate and body temperature.

But every now and then, something goes wrong and a portion, or all, of the thyroid needs to be removed through a thyroidectomy.

The most common reason for a thyroidectomy is the growth of nodules or cysts that are benign, but have become large enough to have a cosmetic or functional impact.

“The indications for surgery typically include cosmetic deformity where you can see those thyroid changes, or symptoms related to compression of the growing nodules and cysts on swallowing and neck movements,” said Dr. Jason Sigmon, an otolaryngologist at UCHealth Ear, Nose and Throat Clinic in Steamboat Springs.

A thyroidectomy may also be necessary to treat thyroid cancer, and in rare cases, it’s done to address thyroid conditions that can’t be managed medically.

“Thyroid conditions are very, very common, and most can be medically managed,” Sigmon said. “A small number are considered for surgical treatment. However, because there are so many underlying thyroid conditions, the number of thyroid surgeries we do is higher.”

Patients with benign nodules or cysts are often asymptomatic, though they may notice a bump or enlarged area in the lower throat when tying a necktie or putting on makeup. A primary care provider may also feel the nodules or cysts during a routine examination.

Issues with thyroid function may be discovered during routine laboratory work, while thyroid cancer may be indicated by symptoms such as a lump or swelling in the neck, pain in the front of the neck, trouble swallowing and breathing.

Sigmon recommends seeing your primary care provider if you have a possible thyroid issue, as they can diagnose and manage a large number of thyroid conditions.

“Many of those issues don’t require a specialist,” Sigmon said. “Patients can rely upon their primary care doctor to make the decision on when it’s necessary to see a specialist, and whether that would be an endocrinologist or an ENT.”

Risk factors for thyroid tumors include a known history of exposure to ionizing radiation or a family history of thyroid cancer. Thyroid issues can strike anyone at any age.

“It hits all age groups,” Sigmon said.

In most cases, thyroidectomy is an outpatient surgery that takes a few hours to perform. One risk of a thyroidectomy is vocal changes due to damage to the laryngeal nerve, but recent surgical advances help prevent that issue.

“The most significant advancement in thyroid surgery is recurrent laryngeal nerve monitoring,” Sigmon said. “This device monitors the nerve during surgery while the patient is asleep and assists the surgeon in the safe removal of the thyroid gland.”

Most patients return to work and normal activities within a week of surgery. “Thyroid surgery is very common and the results are very reproducible and therefore have good outcomes,” Sigmon said.

While patients who have their entire thyroid gland removed will need to take thyroid hormones, Sigmon stressed that in most cases, a partial removal does the job.

“The majority of thyroid surgeries nowadays involve partial removal of the thyroid gland, and only with specific indications do we engage in total removal,” Sigmon said. “In most cases, having thyroid surgery doesn’t commit a patient to having to take lifelong thyroid hormone medication.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

Location update

UCHealth Ear, Nose and Throat Clinic is currently at 940 Central Park Drive, Suite 207, in Steamboat Springs. Effective May 20, the clinic will move down the hall to 940 Central Park Drive, Suite 209.

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