Preparation:

In most cases, surgery of the thyroid is not highly complicated and usually takes no more than two hours. Removal of half of the thyroid takes 45 minutes to an hour, so if the entire gland is being removed, the surgery will last about an hour and a half.

Check with your surgeon about medications you are taking, and what you should/shouldn't take in the days prior to surgery.

You will be asked to check into the hospital the morning of your surgery. Typically, your surgeon will ask that you refrain from eating or drinking after midnight the night before surgery.

Recovery:

You can expect a sore, hoarse throat after surgery. You may also have neck pain and difficulty chewing and swallowing for a few days. You will have a drain placed in the incisions to drain excess fluid. This will remain in place for 24 hours. You may be discharged after a night of observation in the hospital. Depending on the extent of the operation, patients may need to take the drug levothyroxine, an oral synthetic thyroid hormone.

Risks:

In the hands of an experienced thyroid surgeon, thyroid surgery is a safe procedure with few complications.

The main risks of thyroid surgery include:

1. Bleeding in the neck:

As with any operation, there is always a chance of bleeding. The average blood loss for this operation is less than a tablespoon, and the chance of needing a blood transfusion is extremely rare. However, bleeding in the neck is potentially life-threatening because as the blood pools, it can push on the windpipe or trachea, causing difficulty breathing. Fortunately, in the hands of New York Thyroid Center surgeons, the risk of bleeding is less than 1%. Due to this rare risk of bleeding, patients are observed for 6 hours by our highly trained recovery room staff. If there is no sign of bleeding and the patient feels well, he or she may go home. Once at home, patients and their friends/family should watch for signs such as difficulty breathing, a high squeaky voice, swelling in the neck that continues to get bigger, and a feeling that something bad is happening. If any of these symptoms happen, the patient should call 911 first and then their surgeon.

2. Hoarseness (Recurrent laryngeal nerve injury):

There are two nerves called the recurrent laryngeal nerves that run just behind the thyroid. These nerve control the vocal cords. If one of these nerves is injured, the voice may become hoarse. The chance of having temporary hoarseness is 3%, and the chance of having permanent hoarseness is less than 1%. Temporary hoarseness usually gets better within a few weeks but can take up to 6 months to resolve. Even in the rare chance of having a permanently hoarse voice, there are things that can be done to improve or fix the voice.

3. Hypocalcemia (Hypoparathyroidism):

The parathyroid glands are 4 small, delicate glands each the size of a grain of rice that sits behind the thyroid and controls the blood calcium levels. If all 4 glands are injured or removed during the operation, the blood calcium levels can become lower than normal called hypocalcemia. Hypocalcemia can cause symptoms such as numbness and tingling (especially around the lips and in the hands and feet) as well as cramping and even "locking" of the hands and feet. The risk of having a temporarily low blood calcium level is about 5%, and the risk of having a permanently low blood calcium level is less than 1%. It is important to note that numbness and tingling may be caused by something other than a parathyroid problem. If a patient has symptoms caused by low blood calcium, the surgeon may prescribe extra calcium and a vitamin D supplement.

Other risks of thyroid surgery include wound infections and seromas. Wound infections happen in about 1 out of 2000 operations (far less than 1%), and because of this low risk, the routine use of antibiotics is not needed. A seroma is a collection of fluid under the incision. Seromas happen rarely and usually disappear within a few weeks.