Thyroid and Parathyroid Surgery

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Thyroid gland

The thyroid gland is a butterfly-shaped gland, which makes hormones that regulate body’s metabolism. It is located in the middle of the lower neck, below the larynx (voice box) and wraps around the front of the trachea (windpipe).

Diseases of the thyroid gland are very common and affect millions of Americans. The most common diseases are an overactive or an underactive gland. Patients may also develop masses or nodules in their thyroid glands, which can be either benign or malignant.

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The vast majority of thyroid nodules are benign. About 1 in 20 thyroid nodules are malignant. Fine needle aspiration biopsy is a useful test in diagnosing malignancy in a thyroid nodule. During the test, a small needle is passed through the skin and underlying soft tissues into the thyroid nodule and cells are extracted. The cells are then analyzed by a cytopathologist. If a malignancy is diagnosed or suspected, partial or complete removal of the thyroid gland may be necessary. If the nodule is benign, observation with serial ultrasound examinations is often undertaken.

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Thyroid surgery

Thyroidectomy is a surgical removal of part or all of the thyroid gland. Most commonly, a thyroid nodule that is suspicious for malignancy or can not be definitively identified as benign is treated with thyroidectomy. Thyroidectomy is also performed when a large goiter (an enlarged thyroid gland with multiple nodules) forms and puts pressure on the structures in the neck, which can cause difficulty breathing and swallowing.

Thyroid surgery is performed under general anesthesia through a horizontal incision in the low central neck (hidden within a skin crease). Patients stay overnight in the hospital and go home the next day. Recovery is usually rapid, most patients experience little or no pain after the first 24 hours and many return to work with no restrictions within 1 week after surgery.

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Parathyroid glands

The parathyroid glands are four small glands in the neck located on the back surface of the thyroid gland. They secrete PTH, a hormone that helps maintain the correct balance of calcium and phosphorus in the body. If the parathyroid glands secrete too much hormone, a condition known as primary hyperparathyroidism, blood calcium rises. Usually, this condition is due to a benign tumor called an adenoma involving one of the parathyroid glands, causing it to become overactive. In other cases, the excess hormone comes from two or more enlarged parathyroid glands, a condition known as hyperplasia. In very rare cases, hyperparathyroidism is caused by cancer of a parathyroid gland.

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Parathyroid surgery

Parathyroid surgery is usually performed under general anesthesia through a horizonal incision in the low central neck, identical to the incision used in thyroid surgery. Abnormal parathyroid gland or glands are identified and removed. Recovery is usually rapid and most patients return to work with no restrictions within 1 week after surgery.

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