Minimally Invasive Thyroid Surgery for an Enlarged Thyroid
A healthy thyroid is essential to good health. Yet, some people develop enlarged thyroids or thyroid disorders that require surgery. Thyroid surgery is a completely safe and highly effective way to cure thyroid enlargement and certain thyroid disorders. Yes, you can live a happy and productive life without a thyroid. Minimally invasive thyroid surgery for an enlarged thyroid is extremely beneficial to one’s immediate health and can lead to a longer life expectancy. Surgery is often necessary to overcome the dangers and limitations that are common with thyroid disorders.
The thyroid is responsible for thyroid hormone (T3, T4, and calcitonin) production to support energy, metabolism, and body functions. Anatomically, the thyroid gland is in the neck, below the larynx or voice box. Behind the thyroid are the laryngeal nerves and four small parathyroid glands, the left inferior and left superior are on one side of the nerves and the right inferior and right superior are on the opposite side. They are noticeably smaller than the main thyroid gland and primarily responsible for parathyroid hormone (PTH) production to regulate the calcium in the blood.
Is Minimally Invasive Thyroid Surgery Necessary?
Abnormal changes in thyroid size, shape, or function are a common cause of many metabolic conditions, such as obesity, hypertension, hyperglycemia, etc. Surgery is often necessary to remove enlarged or diseased glands to prevent severe adverse effects, and in some cases, cancer. Common thyroid disorders that are curable with surgery include goiters, nodules, cancer, and overactivity. Thyroid enlargement is a common condition many people are not aware they have until abnormalities are identified in their lab results or they develop any or several of the following symptoms.
Unusually large and physically noticeable thyroid goiters or neck growths
Trouble breathing or swallowing
Trouble regulating body temperature (hot flashes, profuse sweating, or chills)
Muscle weakness or pulmonary dysfunction
An unhealthy or dysfunctional thyroid can make daily living extremely challenging and uncomfortable, especially as the condition or symptoms progress. It is not unusual for some people with dysfunctional or enlarged thyroids to remain asymptomatic.
Types of Minimally Invasive Thyroid Surgery Offered at C/V ENT
The surgeons at C/V perform minimally invasive thyroid surgery with endoscopes and eye-loop magnification in the hidden, lower neck creases to enhance patient outcomes. C/V ENT Surgical Group, under the direction of Dr. Alen N. Cohen, MD, offers minimally invasive thyroid and parathyroid surgery options:
Minimally Invasive Parathyroid Surgery
Dr. Bob Armin removes abnormal parathyroid glands with endoscopic tools for those with hyperparathyroidism. Untreated, the condition causes a dangerous spike in blood calcium levels, resulting in hypercalcemia. Hyperparathyroidism is not something many patients are aware of right away because the condition takes a long time to progress. By the time the symptoms become noticeable (i.e., brittle bones, frequent muscle and joint pain, fatigue, and recurrent kidney stones) the most optimal treatment options include monitoring, medication, or surgery. Surgery is the fastest and most effective option to prevent further damage to the body.
Hemithyroidectomy is recommended when a portion of the thyroid gland is dysfunctional and contains abnormal tissues. It is also suitable for patients when half or less of the gland is diseased. Surgery involves the removal of the compromised section of the thyroid, usually one half. The removed tissues are sent for further assessment to determine if the enlargement is cancerous (benign) or malignant.
Complete/total thyroidectomy requires the removal of the entire thyroid gland. To remove the entire thyroid, our surgeons usually make 1.5 inch incision in the lower neck along a hidden crease and section the thyroid gland into smaller pieces for easy removal through the small incision. This allows them to protect the surrounding tissues and nerves in the laryngeal region, so patients have faster recoveries, fewer complication risks, and better results.
Some patients have severely enlarged thyroid glands that interfere with breathing, swallowing and speech. Usually, enlarged goiters that cause these symptoms are not cancerous, or due to hormones or other common disorders that result in thyroid problems. Goiters are unsightly and can severely lessen one’s quality of life.
Sometimes, exploratory surgery is necessary to determine the cause and degree of hyperparathyroidism. Parathyroid surgery involves the removal of all abnormal parathyroid tissues. One or more glands are left to ensure optimal thyroid function. Parathyroid dysfunction is diagnosed with routine blood work and diagnostic tests, such as an ultrasound, sestamibi scan, 4D CT or SPECT scanning. Also, patients with secondary or tertiary hyperthyroidism often undergo exploratory surgery before treatment or additional surgery recommendations are made.
Primary hyperparathyroidism causes hypercalcemia or too much calcium in the blood. It is often caused by abnormal parathyroid gland activity. Secondary hyperparathyroidism causes low levels of calcium in the blood, also known as hypocalcemia. It’s often a direct cause of the parathyroid glands making too much calcium and the kidneys making too little vitamin D to compensate, usually a sign of kidney failure or dysfunction. Tertiary hyperparathyroidism occurs when enlarged thyroid or parathyroid glands remain in an overactive state permanently.
Central and Lateral Neck Compartment Dissection
Depending on the cause and degree of thyroid enlargement or dysfunction, our surgeons may recommend central or lateral neck compartment dissection. Central neck compartment dissection involves the removal of cancerous thyroid tissues in the lymph nodes near the windpipe, below the thyroid (pretracheal, mediastinal, and Delphian areas). Lateral neck compartment dissection involves the removal of lymph nodes in the jugular vein and collar bone regions, it is usually reserved for patients with thyroid cancer that has spread to the lymph nodes.
Minimally Invasive Thyroid Surgery for Enlarged Thyroid at C/V ENT
At C/V ENT, our board-certified surgeons offer minimally invasive thyroid and parathyroid procedures using the latest surgical techniques and equipment. Most minimally invasive treatments are performed at an outpatient surgical center and take less than two hours to complete. C/V ENT surgery patients enjoy less scarring, minimal discomfort, shorter recovery times, and better outcomes.