The butterfly-shaped thyroid gland is located in the neck just below the Adam's apple. You may have noticed a large mass hanging below the throat in some people. This mass is the enlarged thyroid gland tissues or nodules that leads to goiter. The thyroid gland produces hormones, like thyroxine (T4) and triiodothyronine (T3). Thyroid gland releases T4, most of which is converted to T3 outside the body. These hormones are very important for regulating the body temperature, pulse rate, digestive functions, metabolism, and growth. Iodine is a basic necessity for production of T3 and T4, so a deficiency of iodine mostly leads to goiter.
The cause of goiter depends on the type of goiter. The following paragraphs will discuss goiter surgery followed by details on the condition itself.
What is Goiter?
Enlargement or swelling of the thyroid gland is called goiter. There are two conditions that cause goiter: (i) the thyroid gland producing too much hormones -- hyperthyroidism; or (ii) thyroid gland producing too less hormones -- hypothyroidism.
There are different types of goiter -- simple, hereditary, and those occurring due to different causes
- Simple goiters are further classified as endemic and sporadic. They are seen in those who have inadequate supply of thyroid hormone. The thyroid gland enlarges itself to overcome this deficiency of thyroid hormone. People living in a certain geographic area, who do not receive enough iodine in their diet, suffer from endemic goiter. Iodine is a very important essential trace mineral required to produce thyroid hormone. Sporadic causes of goiters are unknown and may occur due to certain types of drugs.
- Hereditary goiter is seen affecting mostly women, who are above 40 or in those who have a family history of goiter.
All About Goiter Surgery
Complete or partial removal of thyroid gland is called goiter surgery, mostly known as thyroidectomy The enlarged thyroid gland that presses the other structures of the throat is removed in the surgery. This is a very simple and safe procedure carried out under anesthesia. The surgeon will remove more than half of the thyroid gland or enough of it that will help reduce the goiter symptoms. Removal of thyroid gland will decrease the production of thyroid hormone and thus, the size of your goiter will be significantly reduced. The remaining thyroid gland will be able to produce enough hormones that will be sufficient for your body's needs. If not, you may have to undergo a lifelong hormone replacement therapy.
The thyroid surgery is significantly a safe procedure. However, in some rare complications, it may include postoperative infections and nerve damage (nerves that help control the voice box). This may lead to a permanent hoarse voice. The parathyroid glands, too, may be damaged. These glands regulate the amount of calcium in the body, and their damage indicates that a person may have to take calcium supplements for the rest of his life. There is only 1 to 2% risk of complications associated with thyroid surgery.
When is Goiter Surgery Necessary
Whether surgery is required or not depends on the type of goiter. The doctor may prescribe antithyroid drugs, radioactive iodine, etc., to reduce the size of goiter or keep it under control. Following are some situations wherein surgery may be recommended:
» If the goiter continues to increase in size despite the goiter treatment given, a surgery may be advised.
» If the goiter compresses the trachea that leads to persistent voice hoarseness, then surgery may be needed.
» Multinodular goiter surgery is carried out if there are more than one isolated lumps observed. The doctor may even ask you to undergo a surgery if he feels the goiter is developing into a malignant or cancerous tissue. If one does not undergo surgery, there are chances of many different complications. These include heart failure, neck injury, and thyroid crisis.
Recovery Period for Goiter Removal Surgery
When one talks about an operation, the first thing that comes to mind is the surgery recovery time. After surgery, one may feel a bit sore and have trouble swallowing for some days. A slight pain may also be experienced after the surgery that can be relieved with painkillers. A thick tube is placed in the area of the surgery for 24 hours to drain out the accumulated fluid. The recovery period for goiter surgery is about 2 weeks. One will be given medications containing thyroxines. These help in replacing the hormones that no longer will be secreted by the thyroid gland. To maintain the level of calcium in the blood, one will also be prescribed with calcium supplements.
Reasons for Goiter
Radiation Exposure - It is a case in which head and neck have been exposed to radiations too many times, which increases the risk of developing a goiter.
Pregnancy - A hormone named human chorionic gonadotropin is secreted more during pregnancies, which can also be a cause of developing a goiter.
Thyroid Cancer - Cancerous nodules can be found in the thyroid gland, which can also enlarge it, resulting in goiter. If the goiter is without any nodules, then there is no need to worry about cancer.
Nodular Goiter - In this case, nodules are formed due to tissue growth on the side of thyroid gland, which later results in its enlargement, causing a goiter.
Hashimoto's Disease - It is an autoimmune disease, which causes inflammation of the thyroid gland, which later does not produce enough hormones and results in goiter.
Grave's Disease - This is also an autoimmune disease in which the immune system of the body attacks the thyroid gland and causes swelling of the gland, forming a goiter.
All goiters are not visible and do not compulsorily show symptoms -- some signs being difficulty in breathing and swallowing, change in voice (getting more hoarse), swelling on the neck, nausea, and increased heartbeat.
Types of Tests
If one experiences the above symptoms of goiter, it is very necessary to meet your doctor and get it checked so that the severity can be measured and actions can be taken over it. Depending on the growth of the goiter, one will have to take the following tests.
Physical Examination - In a physical test, neck palpitation and swelling are checked by the doctor while you swallow to examine the chances of goiter.
Hormone Test - This is a type of blood test in which the hormone levels are checked, which are produced by the pituitary gland as well as thyroid gland. The test results can tell us if one has goiter, or not.
Antibody Test - This test detects antibodies that are produced in certain forms of goiter.
Ultrasound Test - It is an imaging test, in which the size of the thyroid gland is checked along with the presence of nodules to reveal the chances of goiter.
Thyroid Scan - This is also an imaging test that provides all the details of the thyroid gland with its functions. In this test, a radioactive material is injected and then tests are conducted.
CT/MRI Scan - If the goiter is extended too much, then CT or MRI scans are advised, which tells us about its size and the extent of its growth.
Goiter surgery is relatively a simple surgery that helps in controlling the secretion of thyroid hormones. One should make sure that he/she has iodized salt in the daily diet to keep goiter at bay. If you have a family history of goiter, make sure you get yourself tested regularly for thyroid problems. If you still have any further queries regarding the surgery, speak to your doctor for more detailed answers.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical professional.