ENT Clinic of Iowa offers extensive experience in the surgical management of thyroid disorders. As neck surgeons, our physicians have unmatched experience in surgery of the neck. When it comes to both thyroid and parathyroid surgery, our surgeons are among the most experienced in the state of Iowa.
Thyroidectomy – the surgical removal of part or all of the thyroid gland - is indicated for three major reasons, the most common of which is the development of a suspicious lump within the gland. In these cases, initial evaluation typically includes thyroid ultrasound and fine needle biopsy. In some cases, a nuclear radioactive uptake scan is done. Even with these studies, occasionally definitive identification of the lump is not possible. When cancer is suspected, or when the identity of the mass is uncertain, thyroidectomy may be indicated to definitively treat or assess the lump.
Thyroidectomy may also be performed when a large goiter forms and constricts the surrounding structures of the neck. This can cause difficulty swallowing, neck fullness, and a strangulation sensation. Occasionally, a large thyroid can actually push on or deviate the windpipe. In these cases, surgical removal of the thyroid gland may be indicated.
In rare cases, a hyperactive thyroid nodule can form. When this occurs, a single lump in the gland strongly overproduces thyroid hormone, causing hyperthyroidism. When present, surgical removal of this hyperactive nodule is curative of the disease.
In general, patients recover from thyroid surgery very quickly. In most cases, incisions are well-hidden in existing skin creases and are difficult to notice once complete healing has taken place. All surgeons at ENT Clinic of Iowa strive to minimize incision length while maintaining the safety of the procedure. Many patients are candidates for a minimally invasive approach.
[Back to Top]
In some cases, thyroid surgery is indicated in children. This is most commonly performed for the management of Graves Disease, a form of hyperthyroidism. In the case of children, less invasive surgical options are available, including a totally endoscopic approach which greatly decreases post-operative pain and shortens recovery time. This surgical technique avoids any incision on the neck. Instead, tiny incisions are made in the underarm, and the gland is removed using laparoscopic techniques. Most patients require no post-operative prescription pain killers.
[Back to Top]
Hyperparathyroidism (elevated parathyroid hormone level) and hypercalcemia (elevated calcium level) are the most common indications for parathyroidectomy (surgical removal on one or more parathyroid glands). The parathyroid glands are located just behind the thyroid gland and are responsible for calcium metabolism. The prevalence of hyperparathyroidism is reported to be approximately 4 cases in 100,000 persons. Primary hyperparathyroidism affects women approximately twice as frequently as men. Prevalence increases with age, but hyperparathyroidism can affect persons of all ages, including children. In rare cases, hyperparathyroidism can be related to a group of familial cancer disorders.
In primary hyperparathyroidism, one gland is released from normal control of the calcium system and begins to overproduce parathyroid hormone. This drives up the blood calcium levels; over time, the bone calcium levels suffer, osteopenia or osteoporosis can develop, and kidney function can suffer. Other symptoms can include depression, joint pain, muscle weakness and GI difficulties.
Once identified, hypercalcemia due to elevated parathyroid hormone levels is typically managed based on the severity of the calcium elevation. Very mildly elevated calcium levels in asymptomatic patients can be observed with simply monitoring or treatment with medications. When symptoms are present or when calcium levels are unacceptably high, parathyroidectomy is indicated.
In general, patients recover from parathyroid surgery very quickly, with same-day discharge. In most cases, incisions are well-hidden in existing skin creases and are difficult to notice once complete healing has taken place. All surgeons at ENT Clinic of Iowa strive to minimize incision length while maintaining the safety of the procedure. Many patients are candidates for a minimally invasive approach.
[Back to Top]
More on Minimally Invasive Endoscopic Thyroidectomy & Parathyroidectomy
Back to top