What is a thyroidectomy?

Today Dr. Babak Larian joins Dr. Raymond Douglas for Thyroid Thursday to discuss “What is a thyroidectomy?” Dr. Larian is an expert in thyroid function, disease, and treatment.

Where is the thyroid?

The thyroid gland is in the lower part of the neck.

What does the thyroid gland do?

The function of the thyroid gland is to control the metabolism of the body. The brain and the thyroid gland work together to regulate the metabolism levels. Thyroid stimulating hormone (TSH) is sent down from the brain to instruct the thyroid gland to produce thyroid hormone. In response, the gland produces thyroid hormone (T4) and it circulates in the blood. Based on the availability of the T4 in the blood, the brain regulates the amount of TSH.

When patients have hormonal issues, we can figure that out by looking at the level of TSH and the hormones in the bloodstream.

What happens to the thyroid in Graves’ disease?

When a patient has Graves’ disease, there are antibodies attacking the thyroid gland, which abnormally stimulate the hormone. These antibodies attach to the TSH receptors on the thyroid gland and act like TSH. This causes the thyroid gland to produce extra hormone and ultimately leads to inflammation of the gland.

In Grave’s patients, we must decrease the thyroid hormone. This can be done in a few different ways, including medications, radioactive iodine, or thyroid surgery.

What is a thyroidectomy?

Before explaining how he performs a thyroidectomy, Dr. Larian explains how on the back side of the thyroid gland we have our parathyroid glands, which are very important because they regulate the amount of calcium in the body. When performing thyroid surgery, it is very important that we preserve these parathyroid glands. It is also very important to locate the nerves to the voice box to make sure those are protected during the thyroidectomy.

Overall, thyroid surgery is a very delicate procedure. There is a small amount of space and a lot of very important structures involved. The more experienced the surgeon, the more abnormalities and difficulties they have dealt with and therefore know what to do regardless of the patient’s anatomy and condition.

During thyroid surgery for a Graves’ disease patient, the entire gland is usually removed. The incision is usually in the lower neck because it’s right in the middle of the thyroid gland. The incision size is related to the size of the thyroid gland. For example, the larger the gland, the larger the incision needed. When performed by an expert thyroid surgeon, the size of the incision only needs to be approximately half the size of the thyroid because you can remove it one half at a time. Dr. Larian notes that his average thyroid surgery incision size is 1 inch to 1.25 inches.

The skin on the neck is different than the skin on the rest of the body; it is thin, has a lot more blood vessels, and heals faster with less scarring.

When selecting a thyroid surgeon, research shows that a surgeon should be doing 50 or more thyroid surgeries a year because this volume of surgery greatly improves the surgeon’s experience level and significantly reduces the risks associated with the surgeon.

Learn More About Thyroid Surgery

If you would like to learn more about thyroid surgery, please visit Dr. Larian’s website LarianMD.com. Also, now that you know a little more about “What is a thyroidectomy?” you can also contact our office and we can provide you with as much information as possible – 310.657.4302.



Posted in: Thyroid Eye Disease

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