Thyroidectomy

A thyroidectomy is a surgical procedure to remove all or part of the thyroid, a butterfly-shaped gland at the base of the neck. This operation is performed when a patient has thyroid cancer, a goiter (enlarged thyroid gland), or other thyroid conditions.

Thyroid or endocrine surgeons typically perform this procedure, but often collaborate with otolaryngology (head and neck) surgeons to provide the highest level of patient care. As a high-volume thyroid cancer surgery center, Penn Medicine surgeons complete hundreds of thyroid removal surgeries each year. 

Your care team may recommend a thyroidectomy if you have thyroid cancer, hyperthyroidism, goiters, or thyroid nodules. Your surgeon will determine whether to remove all or part of your thyroid gland and what type of thyroid surgery is best for you.

In some cases, both a thyroidectomy and a thyroid lobectomy are treatment options. The surgery performed depends on your preference, and we can help you choose what’s best based on your specific needs.

In other cases, one surgical option is clearly better than the other:

• If you are taking thyroid hormone replacements or have multiple nodules on your thyroid, a thyroidectomy is usually recommended.
• If you have diffuse thyroiditis (inflammation of the thyroid gland causing hypothyroidism), a toxic nodule, or a specific nodule that needs removal, a thyroid lobectomy is often the preferred treatment.

If a thyroid biopsy doesn’t give a clear answer (which happens about 20 percent of the time), doctors might recommend lobectomy surgery to remove part of your thyroid. The tissue will be checked further, and if cancer is found, another surgery might be needed to remove all of it.

If you’re having a total thyroidectomy, we may also remove lymph nodes for examination. We use minimal incisions for better cosmetic results. General anesthesia is used, and you’ll stay overnight.

For a partial thyroidectomy, some thyroid tissue is left to preserve nerve function. This is typically an outpatient procedure performed under general anesthesia. A drain may be used to remove fluid overnight, but most people go home the same day.

In the first day or two after your thyroidectomy or thyroid lobectomy, you may experience a sore throat, neck pain, difficulty swallowing, or a weak voice. Here’s what to expect:

• Post-surgery diet: Your diet will be limited on the evening of surgery, but you can usually return to a normal diet the next day.
• Physical activity: Most people go home within a day of surgery and plan to take about two weeks off work to recover fully. Avoid heavy lifting or strenuous activities that strain your neck for up to three weeks after surgery.
• Incision care: Avoid soaking or scrubbing the incision site for at least a week to promote healing. Showering is usually okay after the first day.
• Pain management: Pain at the incision site usually improves within a few days but may last a week.
• Calcium monitoring: Surgery can sometimes affect the parathyroid glands, which control calcium. If your calcium level drops, you may feel numbness or tingling in your fingers or around your mouth. We’ll provide instructions on taking calcium supplements.

Thyroidectomy is a generally safe procedure when performed by a specially trained and experienced endocrine surgeon. While uncommon, some potential side effects include:

• Bleeding after surgery: This can cause fluid to collect in the lungs’ air sacs.
• Damage to the laryngeal nerve: This nerve controls muscles in the larynx, which can affect the vocal cords that produce sounds.
• Damage to the parathyroid glands: These glands make parathyroid hormones, which can lead to low blood calcium levels.

Penn Medicine thyroid and parathyroid cancer care experts are recognized worldwide for their groundbreaking research in treatments for advanced thyroid cancer. If you choose our specialists for your thyroid removal surgery, you can expect:

• Coordinated care: Your team includes a variety of thyroid cancer specialists with years of experience, including endocrinologists and surgeons, who regularly work together and meet to discuss your case.
• Novel treatments: Research conducted at Penn Medicine led to FDA approval of treatments that have become the standard of care for advanced thyroid cancer—we never stop seeking new ways to treat thyroid cancers.
• Comprehensive support: We connect you with cancer support services like a thyroid cancer oncology nurse navigator, speech language pathology expert, registered dietitian, oncology social worker, support groups, palliative care, and other services to assist you throughout your care journey.