Thyroid Surgery Frequently Asked Questions
If you need thyroid surgery, it is important to know what to expect. The following are some of the most frequently asked questions:
- How long will I be hospitalized?
- Most patients come to the hospital on the morning of their surgery and the majority of patients go home the same day after a 6 hour observation period in the recovery room.
- What type of anesthesia will I have?
- You are given the option of either general anesthesia or local anesthesia. With both techniques your surgeon will perform a nerve block so your neck area is numbed. With local anesthesia, mild sedatives will be given so that you are essentially taking a nap during the operation. This is like the “twilight” anesthesia given during colonoscopy. With general anesthesia, the anesthesiologist gives a slightly bigger dose of anesthetic and places an endotracheal tube to maintain your breathing. The amount of post-op nausea and grogginess is about the same for both local and general anesthesia.
- Will I have a scar?
- Yes. All surgery causes scarring, and how the patient heals the scar is very much dependent on the individual. However, there are some techniques that surgeons use to minimize scarring. These techniques include: smaller incision size, careful incision placement, and hypoallergenic suture material (to avoid inflammation). New York Thyroid Center surgeons make every effort to place the incision in a natural skin line which acts like camouflage. The incision will blend into the skin line and once the redness fades away it is essentially invisible. As a general rule, you should not have a noticeable scar after six months. See Scar Gallery ».
- Will I have pain after the operation?
- All operations involve some pain and discomfort. Our goal is to minimize this discomfort. At the time of operation, your surgeon will give you some numbing medicine which usually lasts about eight hours. Although you should be able to eat and drink normally, the main complaint is pain with swallowing. Most patients take Tylenol® or Motrin® to keep them comfortable at home. Your surgeon will send you home with a prescription for a mild narcotic medication, but patients generally do not need to take it.
- When will I know the final pathology from the surgery?
- The final pathology report requires careful study and occasionally special processing. For this reason, the final report is typically complete by 7 business days after the operation. During the operation, your surgeon may send a frozen section biopsy and the pathologist who will provide a preliminary diagnosis. Your surgeon will discuss with you if the frozen section is necessary.
- Will I have stitches?
- The incision is covered with a clear plastic glue called collodion, which is airtight and waterproof. There is a temporary stitch which will be removed 1 to 5 hours after the operation. You can shower the day after your operation, but we ask you not to swim or soak in a bathtub for a week after. The collodion will fall off on its own in 1 to 2 weeks and at that time, a moisturizer can be applied to the wound to improve healing.
- Will I have any physical restrictions after my surgery?
- In general, you should be eating, drinking, and doing your normal activities the night of the operation. We ask you to avoid heavy lifting and vigorous activity for 1 week after the operation. Most patients are able to return to work within the first or second week of surgery. You should be able to drive as soon as you can turn your head comfortably and if you are not taking narcotic pain medication. You must see your surgeon for a routine follow-up office visit approximately three weeks after surgery.
- What are the complications unique to thyroid surgery?
In about 1 in 100 thyroid operations, the nerves that control the voice are affected by the surgical removal of the thyroid. When this occurs, the main difficulties are projection of the voice and production of high pitched sounds. It is usually described as hoarseness, but will not necessarily be considered abnormal by strangers. Usually, voice changes are temporary, so the voice will return to normal within a few weeks; permanent change is rare.
In about 1 in 300 thyroid operations, the parathyroid glands will not function as a result of surgery. These are four delicate glands that are located near the thyroid. Since the parathyroid glands control calcium levels, their dysfunction usually results in a lowered calcium level. Therefore, some patients require calcium supplements on a temporary basis. If the parathyroids do not function properly, calcium or vitamin D may be needed on a permanent basis.
Both of these possible complications are directly related to the operative experience of the surgeon, and these statistics are based on our own results. Although the risk of these complications cannot be eliminated entirely, they can certainly be minimized in the hands of an experienced thyroid surgeon.
As with any operation, there is a risk of bleeding. In the case of thyroid and parathyroid surgery, the risk is 1 in 300 patients (much less than 1%). Because of this rare chance of bleeding, we keep you in the hospital for 4 to 6 hours after the operation for observation and in certain cases may observe you overnight in the hospital.
Click here to learn about the risks of thyroid surgery.
Radiation-Induced Thyroid Cancer
- Why is radiation-induced thyroid cancer a concern after nuclear accidents?
- The thyroid is one of the most radiosensitive of all organs, meaning that it is particularly vulnerable to developing cancers after radiation exposure.
- How does radiation cause thyroid cancer?
- Iodine is an essential element that is used by the thyroid to produce thyroid hormones. The thyroid cannot tell the difference between radioactive iodine and nonradioactive iodine, so if radioactive iodine is present in the environment, the thyroid will absorb it. Radioactive iodine released during nuclear accidents can damage the thyroid and increase the risk of cancer.
- Did many people develop thyroid cancer after the Chernobyl accident in 1986?
- The incidence of thyroid cancer increased significantly among people exposed to fallout from Chernobyl. About 6000 cases emerged after the accident and more cases are anticipated in the coming decades.
- Will radiation-induced cancer pose a threat to the Japanese (or others) after the Fukushima disaster in 2011?
- The risk of thyroid-induced thyroid cancer after Japan's crisis is minimal, according to experts at the Thyroid Center. Although large amounts of radioactive iodine were released into the environment, the Japanese people were evacuated from the area quickly, and they were instructed to restrict their intake of green leafy vegetables, milk, and water from potentially contaminated sources.
- Do x-rays and CT scans increase the risk of developing thyroid cancer?
- Diagnostic x-rays and CT scans as they are performed today do not increase the risk of thyroid cancer. However, patients undergoing external beam radiation therapy for breast cancer, melanoma, or other cancers may be at increased risk of developing thyroid cancer. Patients should undergo their recommended treatment, as the benefits of therapy far outweigh the risks of thyroid cancer, but should be screened for thyroid cancer on an annual basis.