Surgical removal of the thyroid gland, also known as a thyroidectomy, is typically performed to treat an overactive thyroid or thyroid tumors. This procedure is generally safe, but, as with any surgical procedure, complications may occur. These complications include problems with the parathyroid, damage to laryngeal nerves, bleeding and infection.
The parathyroid glands are located near the thyroid gland and can be difficult to distinguish from the surrounding tissue. As a result, injury to these glands can occur in as many as 24 percent of people undergoing thyroidectomy. A main function of the parathyroid gland is to regulate calcium levels. As a result, parathyroid damage can cause low blood calcium, or hypocalcemia. In most cases, this hypocalcemia is only temporary, though a 2008 study in the "Annals of Surgery" found that slightly more than 1 percent of patients may develop permanent hypoparathyroidism 4. Hypoparathyroidism can be treated with calcium supplements to counteract the hypocalcemia.
Laryngeal Nerve Damage
The superior and recurrent laryngeal nerves are also located near the thyroid gland and can be damaged during surgery. Damage to these nerves can cause partial paralysis of the vocal cords, leading to hoarseness. If both recurrent laryngeal nerves are damaged, the vocal cords can become paralyzed and block airflow into the lungs. This can require emergent treatment to help the patient breathe, including intubation, which involves inserting a tube into the throat to keep the airway open.
Bleeding can occur after the thyroid is removed. Because the thyroid is very near the airway, the blood can accumulate and push the airway closed. Other possible complications include infection of the surgical site. The incision site can also scar abnormally, resulting in the formation of a keloid. Keloid scars can be a cosmetic problem and may itch or be painful. Finally, an abnormal tract called a fistula can form between the wound and the lymphatic system. These fistulas can cause:
- persistent drainage of milky white fluid
- which can lead to dehydration
- loss of salt from the body
- a weakened immune system
- infection of the surgical site
- bleeding problems
Multiple factors affect the risk of complications from thyroid surgery, a 1986 article in the "World Journal of Surgery" notes 2. Total removal of the thyroid may have a higher risk than partial thyroid removal. A higher risk of complications may be present with less experienced surgeons. A 2010 article in the "Journal of the Ayub Medical College of Abbottabad" notes that men and older patients may have a higher risk of complications after thyroid surgery 12.
- Journal of Ayub Medical College Abottabad: Post-Thyroidectomy Complications -- The Hyderabad Experience
- World Journal of Surgery: Total Thyroidectomy -- Complications and Technique
- Current Medical Diagnosis and Treatment; Maxine Papadakis
- Archives of Surgery: Hypoparathyroidism After Thyroidectomy -- A Prospective Study
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