According to the World Health Organization, every third inhabitant of the world suffers from iodine deficiency. There are about 1.5 billion people who are at risk of developing thyroid gland pathology. Among endocrine disorders, the thyroid gland disease occupies the second place after diabetes. Therefore, doctors strongly advise doing ultrasound examinations regularly, in order not to miss the possible development of the disease.
What are the indications for thyroid surgery?
The most common pathology of the thyroid gland is nodes. Most of them are benign, and only 5% of cases turns out to be thyroid cancer. There is a misconception that the node of any size is a reason to conduct an operation. It has been clinically proven that benign nodes do not "degenerate" into cancer. Moreover, patients with nodes up to 1 cm in size do not need treatment at all. Therefore, it is extremely important to know the indications and types of operations on the thyroid to avoid unnecessary surgical intervention.
Operations on the thyroid gland are performed in the following cases:
- a knot of a large size, it squeezes the organs of the neck and causes suffocation, disrupts the swallowing process;
- a large-sized node causes a cosmetic defect, deforming the front surface of the patient's neck;
- the tumor produces hormones uncontrollably (i.e., an autonomous, or toxic, node);
- cancer of the thyroid gland, confirmed by a biopsy.
Types of surgeries:
- Hemithyroidectomy - removal of one of the lobes (and part of the isthmus) of the thyroid gland.
- Subtotal Thyroidectomy - partial resection of the thyroid gland.
- Thyroidectomy is the complete removal of the organ.
- Thyroidectomy with Lymphadenectomy (lymph node dissection) - complete removal of the thyroid gland, lymph nodes, and surrounding tissue.
On the eve of World Thyroid Day (May 25), Professor Andreas Sesterhenn, Head of the Department of Otolaryngology (ENT) in Solingen Klinikum, the Academic Hospital of the University of Cologne (Germany), gave an exclusive interview to Bookimed.
He noted that the determining factor in the treatment of the thyroid gland is the establishment of a correct diagnosis. Also, the doctor answered a number of the most frequent questions from patients concerning the thyroid surgery and rehabilitation period afterwards.
When can stitches be removed?
To close the wounds, we use the dissolvable or absorbable stitches. Therefore, there is no need to remove them. Also, the resorbable stitches have the best cosmetic effect.
When is the adhesive band glued and at what point it can be removed?
The sterile band-aid is applied after the surgical wound is closed. Sometimes we use several strips. You can remove the patch yourself on the 5th-8th day after the operation.
When can I take a shower?
In the absence of contraindications, you can take a shower on the second day. In this case, you can not remove the patch. The wound should not be soaped or rubbed with a washcloth. After the shower, you need to wipe the wound gently until it completely dries. We advise patients to refrain from applying cream during this period.
Is it necessary to use particular medication for wound healing?
No. We do not recommend the use of special ointments, creams or patches for wound healing, as they often act negatively on the healing process and increase the rehabilitation period.
What happens to the removed tissue of the thyroid?
The removed thyroid tissue after the surgery is sent to our pathologist at the Institute of Pathology. He divides it into parts and cuts into tiny plates, each of which stains with different reagents and examines under a microscope. The results of the research are faxed to your PCP, after which the doctor discusses the results of the analysis with you within the framework of a postoperative admission in our outpatient department.
When is an urgent histological examination is necessary?
If there are convincing indications for that, we conduct an urgent histological examination. It means that your surgeon receives the results of a histological examination from the pathologist as early as the day of the surgery. If there is a high probability of benign tumor, it may take up to one week for the results of the histological examination to be obtained.
Should I take hormonal drugs after the surgery?
Everything is purely individual. The need for hormones depends on the amount of the thyroid tissues removed and the results of the histological examination. Drug intake is not required for all patients. Control of blood parameters plays an important role here. Therefore, a follow-up examination by a doctor during the postoperative period is needed.
When should I start taking hormonal drugs for the thyroid treatment?
If the result of a histological examination of the tissues confirms the presence of a benign formation, you can start taking medications for the thyroid gland. Medication is taken in the morning on an empty stomach, possibly about 20 minutes before breakfast.
What should I do if I get a feeling of "tingling" in my fingers after the surgery?
"Tingling" is most often the result of the excitation or removal of parathyroid glands and the associated lowering of the level of calcium in the blood. If you notice a tingling sensation while in a hospital or later, inform your doctor and ask for calcium tablets. If you notice a "tingling" after check-out from the inpatient department, contact your family doctor immediately.
When can I start playing sports?
In the postoperative period, light physical exercises are allowed. It is recommended to abstain professional sports within 14 days after the procedure.
When is a vocal cords check-up performed?
Usually, on the day of the operation, we perform a controlled study of the functions of vocal cords with a flexible endoscope inserted through the nose. It allows us to diagnose possible damage to the nerves of the larynx promptly. In any case, the doctor must conduct a follow-up examination within the first 24 hours after the surgery.
Is there any unique regimen for the vocal cords?
No. Immediately after the surgery, you can speak normally.
Prof. Dr. Med. Andreas Sesterhenn
Professor, Doctor of Medical Sciences Andreas Sesterhenn, Head of the Department of Otolaryngology (ENT), Head and Neck Plastic Surgery specialist.
He graduated from the Martin-Luther-Universität Halle (Germany) and Uniformed Services University of the Health Sciences (USA).