A
GNA Feature by Amadu Kamil Sanah, Toms River, New Jersey, USA
New Jersey, Nov. 30,
GNA – Diseases of the thyroid gland are very common, affecting millions of
people in the globe, but the most common thyroid problems are: An overactive
gland, called hyperthyroidism especially Graves disease, toxic adenoma or toxic
nodular goiter.
Background
Thyroid enlargement
due to over activity (as in Graves’ disease) or from under-activity (as in
hypothyroidism).
An enlarged thyroid
gland is often called a goitre.
Patients with a
family history of thyroid cancer or who had radiation therapy to the head or
neck as children for acne, adenoids, or other reasons are more prone to
developing thyroid malignancy.
How
is a Thyroid disorder Diagnosis Made?
The diagnosis of a
thyroid function abnormality or a thyroid mass is made by taking a medical
history and a physical examination.
In addition, blood
tests and imaging studies or fine-needle aspiration may be required.
According to Dr
Bruce W. Peters, ENT-Otolaryngologist in Toms River, New Jersey, as part of the
exam, doctors will examine your neck and may ask you to lift up your chin to
make your thyroid gland more prominent.
You may also be
asked to swallow during the examination, which helps to feel the thyroid and
any mass in it.
Some other tests
doctors may order include: Evaluation of the larynx/vocal cords with an Eber
optic telescope, An ultrasound examination of your neck and thyroid Blood tests
of thyroid function, A nuclear thyroid scan, ultrasound guided fine-needle
aspiration biopsy and a CT or MRI scan
What
are Thyroid Nodules?
Thyroid nodules are
common, occurring in 15-65 percent of people of all ages. They occur in both
women and men, but are especially common in women (50 per cent of women or
older have had a thyroid nodule).
Usually patients and
their physicians first notice thyroid nodules during a routine physical exam of
the neck area. Sometimes they are found incidentally during a radiographic
evaluation of the neck (such as a CT scan, Xcray, MRI or Ultrasound).
Although the vast
majority of thyroid nodules are benign, the physician should evaluate a
significant thyroid nodule, as approximately 5-10 percent of thyroid nodules
are cancerous.
In general, a
thyroid nodule is considered “significant” if it is one centimeter or larger
and/or presents concerning features on ultrasound.
What
is Thyroid Surgery?
There is no medical
treatment for thyroid nodules.
If a decision is
made that the thyroid nodule needs to be removed, surgical treatment is recommended.
Nodules that are
suspicious or cancerous on biopsy require surgical removal.
Large nodules are
often removed for a number of reasons. Benign large thyroid nodules may cause
pressure symptoms in the throat or cause difficulty swallowing.
Thyroid nodules that
produce excess thyroid hormone may also need to be removed. Some thyroid
nodules are large enough that standard diagnostic approaches prevent accurate
assessment of the possibility of cancer and, therefore, need to be surgically
removed.
Thyroid surgery is
an operation to remove part or all of the thyroid gland. It is performed in the
hospital and general anesthesia is usually required.
Typically, the
operation removes the lobe of the thyroid gland containing the suspicious
nodule or lump. A frozen section (immediate microscopic reading) may be used to
determine if the rest of the thyroid gland should be removed during the same
surgery.
Based on the result
of the frozen section, the decision will be made in the operating room if
removal of any remaining thyroid tissue is necessary. These options will be
discussed with you preoperatively by the doctor.
According to Dr
Peters, as an alternative, he may choose to remove only one lobe and wait for
the final pathology report before deciding, if the remaining lobe needs to be
removed.
If a malignancy is
identified in this way, he may recommend that the remaining lobe of the thyroid
be removed at a second procedure.
What
happens after Thyroid Surgery?
The surgery usually
takes two to three hours, and most patients were watched carefully in the
hospital overnight. Its pain is often minimal, and will take four to seven days
off.
GNA
