Operations
Thyroid gland
General information
The thyroid is a 20-gram endocrine gland located in the anterior part of the neck in front of the trachea. It consists of 2 lobes and the isthmus that joins them. The pyramidal lobe is an elevation of the thyroid upwards. Arterial supply is from the upper thyroid artery branch of the external carotid artery and from the lower thyroid artery branch of the thyroid cavity. Topographically and closely related to the thyroid are the upper laryngeal nerve near the upper thyroid artery and the very important reciprocating laryngeal nerve which is responsible for the mobility of the vocal cords concurrently.
Thyroid function consists of the production of triiodothyronine (T3) and tetriodothyronine or thyroxine (T4) hormones that regulate the metabolism of the body and calcitonine which regulates calcium.
Hypothyroidism
It is a reduction of thyroid function with the most common cause of this being chronic autoimmune thyroiditis (Hashimoto). Rarely, genetic hormone abnormalities can be due to either pituitary or hypothalamic deficiency.
Hyperthyroidism
This is an increase in the function of the thyroid gland and may be due to a toxic adenoma, a toxic multinodular goiter or Basedow-Graves disease. The treatment is conservative initially, but if the disease relapses, surgical treatment is highly recommended especially if there is suspicion of malignancy, in young patients with multiple relapses, in large multinodular goiter and in difficulty of adjusting them.
Thyroid Cancer
Thyroid cancer has unfortunately shown a significant increase in recent years especially in young people. We distinguish well-differentiated carcinomas (papillary and follicular) that make up the vast majority (85-90%) and have excellent prognosis;
Medullary that make up 10% of thyroid carcinomas with a significantly worse prognosis, and anaplastic (undifferentiated) thyroid carcinomas that make up only 1% of them and unfortunately have a 6 month life expectancy.
Thyroid Surgical Procedures
Thyroid operations are always done after discussion with the endocrinologist and the patient in accordance with international guidelines and consist of:
Lobectomy, subtotal thyroidectomy, near total thyroidectomy or total thyroidectomy. Particularly in thyroid cancer surgery, all tumors that have been diagnosed preoperatively with either FNA or open biopsy as well as those suspected of being malignant have definite symptoms.
The use of neuromonitoring during thyroidectomy-to identify and evaluate the functionality of the recurrent laryngeal nerve and vagus nerve- is absolutely essential in re-interventions, difficult anatomical dissections, in cancer and lymph nodes.
Thyroid and Parathyroid Glands
- Total Thyroidectomy or Lobectomy for benign or malignant thyroid disease
- Lymph node dissection Central or Lateral ( for Thyroid Cancer)
- Parathyroidectomy (Tumor removal)
- Thyroglossal duct cyst removal
