To treat hyperthyroidism, patients may take medication such as PTU (Propylthiouracil) or Cablmazole at early stages to suppress thyroid functioning and hence, reduce hormone secretion. Medication is to be taken for 6 to 9 months. Once extraneous causes decrease, dosage can be reduced or the patient can even stop taking medication.
If failed medical treatment, the doctor will arrange for the patient to consume radioactive iodine. Once the thyroid glands absorb the iodine, the radioactive substance will kill the thyroid cells. The doctor will calculate the dosage based on the patient’s body weight. As iodine will only be absorbed by the thyroid glands upon entering the human body, other organs will not be affected. However, patient received radioactive iodine may develop hypothyroidism in long run and they may need to take thyroid replacements. Patient with exophthalmoses, eye problem due to thyrotoxicosis, is relative contra-indicated for radioactive iodine treatment as this may result in deterioration of the eye problem. Puberty, pregnancy and women with breast-feeding are also not advised to receive radioactive iodine treatment. They may elect to undergo traditional surgery or minimally invasive surgery to treat hyperthyroidism.
Traditional total thyroidectomy takes around 2.5 hours and is performed under general anesthesia. The doctor will create an incision of around 4cm on the thyroid gland and directly remove the thyroid gland. Patients may consume food and move around after the surgery, and will be hospitalized for around 3 to 5 days. They must also take thyroid hormone replacements. Patients who have only had part of the thyroid gland removed need not take this replacement. However, traditional thyroidectomy may leave unsightly scars on the neck, depending on the individual.
Minimally Invasive Thyroidectomy
In contrast, endoscopic thyroidectomy will not leave behind unsightly scars. Performed under general anesthesia, the surgeon will first incise four tiny holes in the patient’s underarms and areola, with the largest one of 1.5 cm over the axilla and other three 5 mm incision around the areola. Equipment will then be placed inside the body through the incisions and remove the thyroid glands. A total thyroidectomy takes around 3.5 hours, while a partial thyroidectomy takes around 2.5 hours. Patients will be hospitalized for 3 to 5 days and may resume feeding and move around few hours after the surgery. As the underarms and areola wounds are barely noticeable, and the skin on the areola heals relatively quickly, patients will not be left with noticeable scars after the surgery. Patients who have undergone total thyroidectomy will also need to take Thyroxine as hormonal replacement. This is not necessary for patients who have undergone partial thyroidectomy.
Risks of Goiter Treatment
- Usual surgical risks, including bleeding and infection.
- Damage to the parathyroid glands, cramping occurs more easily and calcium deficiency. However, this situation is rare and patients can recover quickly even when it occurs. It is advisable to consult an experienced thyroidologist.
- Laryngeal nerve damage, voice may become coarse, but this situation is rare.
Will there be insufficient thyroid secretion?
Apart from secreting excessive hormones, the thyroid glands may also secrete insufficient hormones due to chronic inflammation. When patients experience thyroiditis over long periods, the thyroid glands may degenerate prematurely. Thyroid tissues will slowly be replaced by scars, causing insufficient hormone excretion. Symptoms include fatigue, weight gain and leg oedema. The cause for this is unknown. Hypothyroidism can be treated by thyroid hormone replacements.
The information provided on this website is for educational purposes only. Please consult your physicians before considering treatment or for detailed medical advice.