A thyroidectomy is a surgical procedure that removes all or part of the thyroid gland, an organ in the neck that regulates the body’s metabolism. This gland produces hormones influencing functions like heart rate and energy levels. This article details potential complications, focusing on the most common post-operative issue.
Thyroidectomy Explained
Individuals may require a thyroidectomy for several reasons, including thyroid cancer, an enlarged thyroid gland (goiter), or an overactive thyroid (hyperthyroidism). A goiter can sometimes become large enough to cause difficulty breathing or swallowing by pressing on the trachea or esophagus. Thyroid nodules, which are growths on the gland, may also necessitate removal if they are suspicious for cancer or producing excess hormones. The extent of the surgery can vary from removing only a portion of the gland (partial thyroidectomy) to removing the entire gland (total thyroidectomy), depending on the underlying condition.
The Most Frequent Post-Surgery Issue
The most common issue after a thyroidectomy is transient hypocalcemia, which refers to temporarily low calcium levels in the blood. This complication occurs because the parathyroid glands, typically four small glands located behind or near the thyroid, regulate calcium levels in the body. During thyroid surgery, these glands can be inadvertently injured, have their blood supply compromised, or experience a temporary “shock” due to inflammation, leading to a decrease in parathyroid hormone production.
While transient hypocalcemia is far more common, resolving within weeks to months, permanent hypocalcemia can occur if the parathyroid glands are severely damaged or removed.
Dealing with Low Calcium Levels
Symptoms of low calcium levels, or hypocalcemia, often include numbness or tingling sensations. These commonly affect the fingers, toes, and the area around the mouth. Some individuals may also experience muscle cramps, spasms, or a crawling sensation on the skin. These symptoms typically become apparent within 24 to 48 hours following the surgery.
Diagnosis of hypocalcemia involves blood tests to measure calcium levels. If symptoms arise, healthcare providers usually recommend oral calcium and vitamin D supplements as the primary treatment. Vitamin D aids in the absorption of calcium, and the combination has been shown to be more effective in preventing post-operative hypocalcemia. In more severe cases, intravenous calcium administration might be necessary to quickly restore calcium levels. Patients experiencing any of these symptoms should contact their medical team promptly for guidance.
Other Potential Concerns
Beyond hypocalcemia, other less frequent but important complications can arise after thyroidectomy. One such concern is injury to the recurrent laryngeal nerve, which can lead to changes in voice, such as hoarseness or weakness. While temporary voice changes are more common, permanent changes are rare.
Another potential issue is the formation of a hematoma, which is a collection of blood around the surgical site. This can cause swelling, pain, and pressure in the neck. Although these complications are less common compared to hypocalcemia, they still require attention. Patients should report any unusual or severe symptoms to their medical professionals without delay.