A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism).Other indications for surgery include cosmetic (very enlarged thyroid),or symptomatic obstruction (causing difficulties in swallowing or
breathing). One of the complications of "thyroidectomy" is voice change and patients are strongly advised to only be operated on by surgeons who protect the voice by using electronic nerve monitoring. Most thyroidectomies are now performed by minimally invasive surgery using a
cut in the neck of no more than 2.5 cms(1 inch).
The thyroid produces several hormones, such as thyroxine (T4), triiodothyronine (T3) and calcitonin.
After the removal of a thyroid patients usually take prescribed oral synthetic thyroid hormones to prevent the most serious manifestations ofthe resultant hypothyroidism.



Less extreme variants of thyroidectomy include:

• "hemithyroidectomy" (or "unilateral lobectomy") -- removing only half of the thyroid
  
• "isthmectomy" -- removing the band of tissue (or isthmus) connecting the two lobes of the thyroid
  

A "thyroidectomy" should not be confused with a "thyroidotomy" ("thyrotomy"), which is a cutting into (-otomy) the thyroid, not a removal (-ectomy) of it. A thyroidotomy can be performed to get access for a median laryngotomy, or to perform a biopsy.
(Although technically a biopsy involves removing some tissue, it is
more frequently categorized as an -otomy than an-ectomy because the volume of tissue removed is minuscule
Indications

• Malignancy (see Thyroid neoplasm)
  
• Cosmetic reasons
  
• Goiter which is untreatable by medical methods
  
• Severe hyperthyroidism refractory to conservative treatment
  
• Orbitopathy in Graves' disease
  
• Removal and evaluation of a thyroid nodule whose FNAC results are unclear
  

Fine Needle Biopsy of Thyroid Nodule

https://www.youtube.com/watch?v=CN5yFGaMDCs&feature=player_embedded

• Types of Thyroidectomy
  
• Hemithyroidectomy - entire isthmus is removed along with 1 lobe. Done in benign diseases of only 1 lobe.
  
• Subtotal thyroidectomy - done in toxic thyroid. primary or secondary and also for toxic MNG
  
• Partial thyroidectomy - removal of gland in front of trachea after
  mobilisation. It is done in nontoxic MNG. role is controversial.
  
• Near total thyroidectomy
  - Both lobes except the lower pole which is very close to recurrent laryngeal nerve and parathyroid is removed. In papillary carcinoma thyroid.
  
• Total thyroidectomy- Entire gland is removed. Done in case of follicular carcinoma of thyroid, medullary ca of thyroid.
  
• Hartley Dunhill operation-
  removal of 1 entire lateral lobe with isthmus and partial/subtotal removal of opposite lateral lobe. It is done in non toxic MNG.
  

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Hemithyroidectomy



Thyroidectomy