Med Treatment

What is a Goiter?

It is an enlargement of the thyroid gland which is located in the lower part of the neck. Goiter can occur when the thyroid gland is inflamed, occupied by tumors or inefficient in making thyroid hormones.

Types of goiter

Diffuse goiter: The enlargement is smooth and generalized
Nodular goiter: Enlargement is due to the growth of one or multiple nodules within the gland.
Nontoxic goiter: It continues to produce the proper amounts of thyroid hormones. It is also called a euthyroid goiter.
Toxic goiter: It can develop in conditions with overproduction of hormones or insufficient thyroid hormones.

Indications for goiter removal

If the enlarged thyroid gland causes compression on other structures such as esophagus and trachea. These patients will usually complain of a cough, nighttime choking episodes or a slight change in voice.
If the enlarged thyroid gland causes compression in the blood vessels of the neck.
If malignancy of the enlarged thyroid is suspected.
For cosmetic reasons
Benefits of goiter removal surgery
Surgical removal of a goiter can relieve compression of structures on the neck such as the trachea.
Removal of symptoms such as a cough, difficulty swallowing or shortness of breath
Goiter removal can cure certain forms of hyperthyroidism associated with goiter

Removal of goiter through surgery

If you do not respond to thyroid hormone therapy, your doctor may recommend surgery to have the goiter removed. Thyroid surgery can remove part, half (hemi thyroidectomy or thyroid lobectomy) or all of the thyroid gland (total thyroidectomy).

The procedure

Thyroidectomy is performed under general anesthesia. This means that you will be unconscious and feel no pain.
The surgeon makes an incision in the front of your neck. This is to enable them to see the thyroid gland.
The surgeon then removes the all or part of the thyroid gland. How much of the gland is removed depends on the underlying cause of the goiter?
This procedure reduces the amount of thyroid hormones being produced as well as the size of the goiter.
The surgeon will aim to remove enough of the gland to relieve symptoms but enough to maintain normal thyroid hormone production.
However, if the entire gland is removed you will require hormone therapy after surgery.

Nerve damage

The thyroid gland is located close to the laryngeal nerves which may be damaged during surgery. These nerves control your vocal cords and if they are damaged it could affect your breathing and voice. Some degree of voice loss can be experienced. If breathing difficulties are experienced, a hole is created connecting the windpipe to the front of the neck (tracheotomy)

Parathyroid gland damage

This gland regulates the amount of calcium in your body. If it is damaged, you will most likely require calcium supplements for the rest of your life. If the glands are damaged, it results in numbness, tingling and muscle cramps. This can also lead to seizures or throat spasms.