The thyroid gland is the largest (endocrine) gland in the human body. It lies in the lower part of your neck, just below your Adam’s apple. Its shape resembles that of a butterfly and consists of two lobes, the right and the left lobe, that are joined together by a narrow strip of tissue, the isthmus.
The thyroid gland is responsible for the optimal functioning of the organism (homeostasis). It controls many of your body’s important functions by producing and releasing certain hormones, the Tetraiodothyronine or Thyroxine (T4) and Triiodothyronine (T3) that regulate various metabolic activities of the body. Behind the thyroid gland, there are four small glands, the parathyroid glands, which are responsible for regulating blood calcium levels.
Thyroid Gland Disorders
The dysfunction of the thyroid gland can cause hypothyroidism or hyperthyroidism, functional diseases, which do not necessarily change the morphology of the gland. These diseases are initially treated with drugs, in order to regulate the secretion to normal levels. In cases where the treatment with conservative means is not effective, the surgical removal of the thyroid (thyroidectomy) is the one that offers the final solution. In addition to the functional diseases of the thyroid, there are also the morphological diseases, which usually do not affect its function. They are due to the presence of one or more nodules (spherical nodules), which change the shape and size of the gland. These diseases include nodular and multinodular goitre (nodular hyperplasia).
The most common thyroid gland disorder is the multinodular goitre, a goitre where there are many lumps (nodules) that appear within the gland and its treatment is rarely possible with medication.
In particular, goiters that disturb breathing and swallowing, those that are submerged in the patient’s chest (substernal goiters), those that overproduce hormones as well as those that are malignant need surgical treatment.
The thyroid cancer, although rare, is the most common endocrine gland cancer. It occurs in 1-2% of the general population and mainly in women. The forms of thyroid cancer are the following: papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer (MTC) and anaplastic thyroid cancer (anaplastic thyroid carcinoma) which is the most aggressive form of thyroid cancer that quickly spreads to other parts of the neck and body.
The thyroid disorders quite often require the surgical removal of the thyroid gland, especially since there are currently no valid diagnostic methods that could rule out the presence of carcinoma.
Total thyroidectomy is a delicate procedure that requires knowledge, experience, absolute skill and attention of the surgeon in order to avoid injury or damage to other organs, such as the laryngeal nerves (that are responsible for swallowing, voice and breathing), the esophagus, the carotids as well as the parathyroid glands. It is recommended in cases of large goiter that disturbs breathing or swallowing and multinodular goiter, which are not treated with medicine, toxic nodular goiter due to risk and in cases of nodules that grow despite treatment or when malignancy is suspected.
Thyroidectomy is performed through a 3-4 cm transverse cervical incision. The surgical incision is made in such a way that it is “hidden” in a natural skin crease which acts as camouflage and the wound is sutured with an intradermal suture (plastic surgery suture). After the operation, the patient must follow lifelong therapy with thyroid hormone.
The thyroidectomy lasts about 2 hours and most of the patients are ready to return home within one day of surgery and to their daily activities in a few days.
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