The thyroid gland is located in the front of the neck and is a butterfly-like organ in appearance. One of the most important tasks of the thyroid, which weighs 20-25 grams on average, is to produce and secrete thyroxine hormone. This hormone regulates the metabolic functioning and metabolic speed of the body. Another task of the thyroid gland is to regulate the body's energy consumption. In addition, a normal thyroid secretion and levels is called euthyroidism, a deficiency is called hypothyroidism, and an excess is called hyperthyroidism. Enlargement of the thyroid is also known as goiter. If the growth involves the entire gland, it is considered diffuse or if the growth is rather focal in the size of chickpeas for example it is said to be nodular. So, what is goiter surgery?
This procedure is applied to patients with the following symptoms:
- People with a thyroid gland that is large enough to put pressure on the neck
- Patients who cannot be treated even if they use drugs for a long time
- Even if they have small nodules, they are at risk of cancer
- Those who have both aesthetic and dangerous swelling on their neck
One of the conditions that require thyroid nodule surgery is iodine deficiency. This is among the main causes of thyroid nodules in the world. The iodine deficiency experienced by the person sometimes causes thyroid enlargement with nodules. This condition is called nodular goiter or multinodular goiter and in these cases the surgery can be applied.
Growths in the thyroid tissue can be seen as nodules and this condition is called thyroid adenoma. These sometimes release too many hormones and can cause the thyroid gland to overwork. This condition is called an autonomous nodule. In addition, a nodule-like condition can be experienced in the aseptic inflammation of the thyroid gland. Cancer in the thyroid gland can also manifest itself as a nodule. Especially people who have been given radiation to the neck area before, who are under 20 or over 60 years old, have a family history of thyroid cancer, and have stiffness and swelling on the sides of the neck have a high risk of having cancerous nodules. Therefore, a diagnosis should be made without wasting time.
Patients who want to have goiter surgery should pay attention to some points before surgery. Things to consider are as follows:
- If the patient needs surgery and T3, T4, TSH hormone levels are within normal limits, a direct surgery plan is made. However, if the person has high hormone levels, surgery can be dangerous.
- The patient goes through the first examination of the internal medicine or endocrinology specialist, and after this examination, the hormone levels are normalized with the necessary medication. If normal hormone levels are observed at the end of this process, the patient is operated.
- In some cases, it may take several months for some patients' hormone levels to return to normal. It is important that patients in this group continue their medication until the day of surgery.
- Patients who routinely use anticoagulants should also stop these drugs before the surgery, wait at least 56 days, and then go into surgery. The use of these drugs can be started after thyroid surgery.
- The patient should not consume solids and liquids for 24 hours before surgery.
Thyroid, also known as goiter surgery, begins by making a 4-5 cm incision in the anterior region of the neck. In the first stage, the thin muscles just under the skin are reached, and then the thyroid gland is found. Since the thyroid gland is an organ with two wings just like a butterfly, first one wing and then the other wing is separated from the trachea.
One of the issues that patients struggle with after goiter surgery is nutrition. In this period, the recovery process of people who eat adequately and in a balanced way goes more smoothly and dynamically. Therefore, it is necessary to acquire healthy habits in nutrition. Vitamins A, B and K should be added to your diet after thyroid surgery. Fish consumption can also be increased during this period. In this context, a dynamic recovery process can also be achieved by adding walks to your routine.
“How long does the goiter surgery take?” It is one of the topics of interest. Although it varies from patient to patient, it takes an average of 2 hours and the patients are kept under observation for 1 night.
One of these techniques is nerve monitoring technique. With this technique, the nerves are protected.
NERVE MONITORING TECHNIQUE
Monitoring of lower (Inferior) Nerves: For the majority of patients receiving general anesthesia, a tube is placed into the patient's trachea (after the anesthesia procedure) to ensure the patient's breathing. In this way, the nerve is stimulated at different stages of the surgery and possible points of problems are noticed and avoided.
Monitoring of the upper (superior) nerves: With this procedure, it is determined whether there is damage to the superior nerve. Thanks to this technique, the surgery can be performed more safely and quickly. In addition, it can be predicted whether the patient will encounter any voice problems after the procedure while under anesthesia.
It is one of the issues that are wondered whether there will be shortness of breath after thyroid surgery.
In thyroidectomy surgery applied for the thyroid glands, an incision of 8-10 cm is made on the front of the neck parallel to the bed and skin lines. After the surgery, this incision is closed with a bandage and a drainage is placed. This dressing is opened 2 days after the procedure, but the drainage remains for a minimum of 2 days. If the patient does not experience any shortness of breath, infection or retraction of the wound after removal of the drainage, the patient can be discharged. After discharge, dressing is done once every 2 days and the stitches are removed on the 7th day. After all these procedures, a special prescription is prepared for the patient. Painkillers and antibiotics are prescribed according to the general condition of the patient, and the patient can be referred to the internal medicine endocrinology polyclinic for the follow-up of the patient and the implementation of the necessary treatment.
Bleeding may occur at the surgical site in the early postoperative period. This complication can happen while you are in the hospital. In this case, the wound is reopened and bleeding is stopped. In addition, the person may experience pain at the wound site. In order to reduce this pain, the patient can be given painkillers. This sore throat is also dependent on the intubation tube placed in order to put the patient to sleep during the surgery.
After thyroid surgery, the stitches in the wound are removed and after this area heals, the scars remain vaguely like a contour scar. However, prominent scar tissue called keloid may also occur on the neck of the patient. This formation and the remaining traces differ from patient to patient.
After the operation, the patient may have hoarseness of voice. This situation may be temporary, it depends on the narcosis tube, inflammation and edema around the nerves in the area. In addition, hoarseness can be permanent with paralysis of the vocal cord.
Permanent or temporary shortness of breath may also occur after surgery. Patients experiencing this condition should consult a doctor without wasting time. In addition, after the surgery, the person may experience a decrease in calcium value in the early or late period. As a result of this, tingling, muscle spasms or numbness may occur around the lips and face and in various parts of the body.