What is a thyroid nodule?
The thyroid gland is an endocrine gland located at the front of the neck. It functions to produce hormones that regulate the body’s metabolism. Patients often visit the doctor after noticing or feeling a lump in the neck themselves, where the lump moves up and down when swallowing. Patients need to undergo diagnostic tests to assess the possibility of thyroid cancer, which occurs in about 10% by blood tests to check thyroid hormone levels, considering an ultrasound of the neck to observe the characteristics and location of the lump, followed by fine needle aspiration biopsy to examine the cells.
When is thyroid surgery necessary?
Thyroid diseases are divided into 2 groups, so the treatments differ.
- The first group is when blood tests show high thyroid hormone levels, called hyperthyroidism. The main treatment is medication to adjust hormone levels, but if it cannot be controlled and the lump is large, surgery will be considered.
- The second group is when blood tests show normal thyroid hormone levels but a lump is found, called thyroid tumor, which may occur on one or both sides.
Indications for surgery are as follows:
- Fine needle aspiration biopsy results show thyroid cancer
- Fine needle aspiration biopsy results show borderline abnormal cells, increasing the chance of cancer
- Fine needle aspiration biopsy results show benign tumors, but the lump is large, from 2-4 centimeters or more, or there are multiple lumps, with symptoms of compression on adjacent organs such as the trachea or esophagus
Types of thyroid surgery
- Open thyroid surgery is the traditional standard surgical method. It can remove thyroid tumors of any size, including thyroid cancer. However, patients will have a surgical scar on the neck, which may affect confidence and quality of life.
- Endoscopic thyroid surgery uses a high-resolution camera with precision and clarity to assist in surgery, resulting in no scar on the neck. It is suitable for thyroid lumps up to 6 cm in size.
What is transoral endoscopic thyroid surgery?
Transoral endoscopic thyroid surgery is a new endoscopic thyroid surgery technique that results in a small surgical wound hidden inside the lower lip, so no scar is visible on the skin surface. Additionally, the distance from the incision to the thyroid gland is the shortest compared to other endoscopic techniques, reducing inflammation of surrounding tissues. The surgical wound heals quickly, and both thyroid lobes can be removed simultaneously. The nerves supplying the vocal cords can also be clearly seen. This method provides good treatment outcomes and safety comparable to the standard open thyroid surgery.
Postoperative care after transoral endoscopic thyroid surgery
- Patients will need 2 days of recovery after surgery
- Eat soft foods for 2-3 days, then resume normal diet
- Take antibiotics for 1 week
- Can bathe and clean the body as usual
- Avoid coughing, sneezing, straining during bowel movements, heavy lifting, or strenuous exercise for at least 1 week
- Start mouth and neck exercises 1 week after surgery
Dr. Prachya Maneeprasopchok
Specialist in Head and Neck Oncology
Ear, Nose, and Throat Center, Phyathai 1 Hospital
