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Thyroidectomy surgery is the removal of all or part of the thyroid gland. This important gland, located at the bottom and front of the neck, produces thyroid hormones that regulate energy production in the body. A healthy thyroid gland has a butterfly-like shape where the left and right lobes are connected by a bridge. Depending on the reason for thyroidectomy surgery, all or part of the thyroid gland is removed. Thyroidectomy surgery is generally a safe surgical procedure. However, some people experience early and late complications of thyroidectomy.

Why is thyroidectomy performed?

A doctor may recommend thyroidectomy for the following reasons:

• Thyroid cancer: Cancer is the most common reason for this procedure. If the patient has cancer, a significant part or all of the thyroid gland may be removed. So, these patients should be aware of the postoperative complications of thyroid cancer and take a lot of care after the operation.
• Enlarged thyroid (goiter): Removal of all or part of the thyroid gland is recommended for people who have goiter and are unable to breathe or swallow comfortably. Also, if the goiter has led to hyperthyroidism, surgery is recommended.
• Hyperthyroidism: Hyperthyroidism is a disease in which the thyroid gland produces too much thyroxin. If you have problems taking medicines and do not want to do radioactive iodine treatment, thyroid surgery is a suitable option.
• Suspicious thyroid nodules: Some thyroid nodules cannot be diagnosed as cancerous or not after sampling. Doctors use thyroid surgery in cases where the nodules have a high risk of cancer.

Some Early and late complications of thyroidectomy

• The most important late complications of thyroidectomy

1-Damage to the vocal cords

In some patients, the tone of the voice becomes hoarse. Temporary voice changes may occur in 5-10% of patients after thyroidectomy. This problem is temporary and is usually caused by irritation of the vocal nerves due to moving them during thyroid gland surgery or due to inflammation after surgery. Voice change usually resolves within a few weeks after thyroid surgery, although it may take more than 6 months.

But sometimes damage or paralysis of the vocal cords happens and causes changes in a person's voice. Also, if the external branch of the superior laryngeal nerve is damaged, the vocal cords may not work properly. However, there may be problems with making high-pitched sounds and shouting. This type of voice change is more common but usually not very noticeable.

2-hypocalcemia

The four parathyroid glands, which are responsible for controlling the body's calcium level, are located behind the thyroid gland and may be damaged during thyroidectomy. Approximately 5% of patients experience temporary symptoms of low calcium levels even if there is no intraoperative injury. One of the causes is vitamin D deficiency, which is very common. But this condition is also temporary and can last up to 6 months and can be solved by taking calcium and vitamin D supplements. To prevent this complication, in some cases, the thyroid surgeon routinely prescribes vitamin D or calcium D tablets a few days before the thyroid surgery.

• The most important early complications of thyroidectomy:

Nausea and vomiting: after thyroidectomy, vomiting and nausea are considered normal. Various drugs are used to reduce the incidence of vomiting and nausea and their symptoms.

Stiffness and pain in the neck: During the surgery, the patient's neck is in a fixed position for a long time, which leads to pain and stiffness in the neck muscles.

Difficulty swallowing (dysphagia): Difficulty swallowing is a common early complication that is usually transient. In these cases, it is recommended to eat soft foods for the first few days.

Hypothyroidism: People who have a total thyroidectomy, which removes their entire thyroid gland, need lifelong thyroid hormone replacement.

Bleeding or hematoma: Bleeding of tissues around the neck after surgery is very common. Bleeding can be dangerous if not diagnosed on time and treated quickly. Most hematomas occur within the first 24 hours after surgery.

Permanent hyperparathyroidism: In some people, temporary hyperparathyroidism may occur, which can be caused by damage or destruction of the parathyroid glands. This disease is sporadic because only one of the four parathyroid glands is enough to regulate the calcium level.

Infection: There is a risk of infection in any type of surgery. However, it is sporadic in thyroid surgery and occurs in approximately 1 in 2,000 surgeries.

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