Thyroidectomy is considered safe, but you should know about the thyroid surgery complications, which are more likely to occur during or after the operation.
The chances of complications during or after thyroid surgery are certainly very low, thanks to the improved surgical techniques and sterile surgical arenas. But it is necessary to give an idea about the possible difficulties to the patient who is about to undergo the procedure. This is performed to treat various problems, like thyroid cancer, overactive thyroid or hyperthyroidism, thyroid nodules, etc.
Surgery is recommended if the patient has Graves’ disease and other treatment strategies have failed. This organ regulates the rate of metabolism and helps maintain calcium levels. During the procedure, when a part of the gland is removed, it is known as subtotal thyroidectomy; when the entire gland is removed, it is known as total thyroidectomy.
Problems, such as damage to the sympathetic trunk, damaged or nicked parathyroids are very rare. Therefore, permanent hypoparathyroidism is rarely reported, but studies show that transient hypoparathyroidism is experienced by approximately 7% of patients.
Surgeons do take precautions to minimize each patient’s risk, but still, patients may suffer from minor to major problems. Minor ones include development of seromas, poor scar formation, pain when swallowing, neck stiffness, etc. Small seromas found at the surgical site after the operation may be allowed to resorb if they are not causing any trouble. Large seromas are usually removed by suction under sterile conditions. An expert surgeon designs a small incision in such a way that the resultant scar will be very small. Excessive retraction is avoided to minimize the damage to the skin. If any such damage is noticed, the skin edges are resected before the final closure at the end of the operation.
Intra-operative or postoperative bleeding, injury to the recurrent laryngeal nerve (RLN), injury to the superior laryngeal nerve (SLN), thyrotoxic storm, infection, hypoparathyroidism are some of the major difficulties, which are more likely to occur after total thyroidectomy or repeat surgery or central neck dissection for cancer. Bleeding can lead to other anatomic problems. Patients should watch for symptoms, like neck swelling, neck pain, and signs and symptoms of airway obstruction. They need to consult the surgeon immediately if they notice any such symptoms.
Symptoms of hypoparathyroidism, which may appear during the first week after the procedure are numbness and tingling in your skin, around your lips, hands, and the bottom of your feet; severe headache, muscle cramps and spasms, anxiety and depression, etc. These can be the symptoms of lowered calcium level, called hypocalcemia. Doctors usually recommend temporary calcium supplementation. You can buy calcium tablets before the operation. It has been noticed that the tingling sensation and numbness usually subsides within 20 – 30 minutes after taking calcium. The hypocalcemia usually goes away in 7 to 10 days.
Symptoms of laryngeal nerve damage include hoarse voice, voice fatigue, decreased vocal range, difficulty projecting the voice, etc. Permanent damages are rarely reported. Usually, the patient can speak normally after a few weeks. Use of surgical devices like nerve monitors can significantly reduce the risk of damage.
Tachycardia and hyperthermia in anesthetized patients or nausea, tremor, and altered mental status, even cardiac arrhythmias in awake patients indicate thyroid storm, which may progress to coma. This rarely happens and appropriate medical treatment can help prevent it. An experienced surgeon who has perfect knowledge of the anatomy and the risks involved knows how to avoid these problems.
Liquid diet is recommended for the first two days after the operation. From the second or third day, the patient can take a bath or shower, but he/she needs to take proper care of the operated area. That area should be ‘pat-dried’. There might be pain while swallowing, but if you have difficulty in breathing, then you must immediately contact your surgeon.
The recovery time depends upon the patient’s age, overall health, and the nature and severity of the procedure. Those who have undergone total thyroidectomy may suffer from hypothyroidism. They should take the prescribed medicines regularly and follow the instructions of the doctor religiously. Regular follow ups are necessary to avoid infection.
To avoid these problems, you need to choose an experienced surgeon. The surgeon’s experience significantly contributes to easy and fast recovery. It should be borne in mind that most of the above mentioned problems are uncommon, and can usually be avoided with the help of an experienced surgeon and sound operative technique.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.