The most common thyroid gland pathologies include thyroid nodules, goiters (thyroid enlargement), hyperthyroidism (overactive thyroid), and thyroid cancer.
Thyroid nodules: The vast majority of thyroid nodules are benign, and can be safely observed without the need for surgery. Thyroid nodules may require further work up in the form of ultrasound imaging, needle biopsy, and molecular testing, to ensure that they are benign. Surgery may occasionally be required if nodules are causing symptoms, are a cosmetic concern, or if malignancy cannot be confidently ruled out. Professor Sheahan is an expert in thyroid nodule evaluation and management and will be happy to perform full evaluation of thyroid nodules and advise management accordingly.
Goiter: Occasionally, the thyroid gland may become grossly enlarged and be a cause of symptoms of neck pressure, tightness, swallowing problems, or even breathing difficulty. Goiters may be visible in the neck, or may extend downwards into the chest where the risk of symptoms may be higher. For large goiters, surgery may occasionally be necessary to alleviate or prevent symptoms. Professor Sheahan will be happy to perform full evaluation of goiters and advise management accordingly.
Hyperthyroidism: The most common causes of hyperthyroidism include Graves disease or “toxic” nodules. The first line treatment for hyperthyroidism is usually medical treatment, which is generally commenced by your GP or Endocrinologist. For cases that are not responding to medical management, or where there is relapse of hyperthyroidism after discontinuation of medical management, surgery may be advised by your Endocrinologist. Surgery for hyperthyroidism is generally considered highly specialized. Professor Sheahan is an expert in hyperthyroidism surgery and has performed over 300 cases with an extremely low rate of complications.
Thyroid cancer: Many cases of thyroid cancer are slow growing and have an excellent cure rate. A minority of cases are more aggressive and require more aggressive treatment. For many cases, partial removal of the thyroid gland is adequate treatment; in other cases, total thyroidectomy with or without removal of lymph nodes or other structures may be required. All thyroid cancer cases are discussed at a specialist Thyroid Multidisciplinary Meeting (MDM). Professor Sheahan is an expert in thyroid cancer and will be able to offer complete evaluation and expert surgical management, as well as long-term follow-up.
Risks of Thyroid Surgery
The major risks of thyroid surgery are neck haematoma (bleeding requiring return to the operating theatre), and damage to the recurrent laryngeal nerve leading to long-term weakness of voice. The risk to the recurrent laryngeal nerves is minimized by use of intraoperative nerve monitoring for all thyroidectomy and parathyroidectomy operations. After total thyroidectomy, patients may experience temporary or long-term hypocalcaemia (drop in blood calcium levels), due to trauma to the parathyroid glands, which are tiny glands very closely related to the thyroid glands. We keep all patients in hospital for 1 night. For patients undergoing total thyroidectomy, we do a blood test the morning after surgery (PTH levels). If this is normal, patients can go home; if it is low, then there is a risk of hypocalcaemia, so patients may need to be started on calcium tablets, and / or stay in hospital for some extra days until calcium levels have stabilized. In addition, all patients undergoing total thyroidectomy will need lifelong thyroid hormone replacement (eltroxin). Around 25% of patients undergoing partial thyroidectomy will require thyroid hormone replacement. Patients should visit their GP 6 weeks after the surgery for blood tests (thyroid function tests) to check if their thyroid function is adequate. Finally, there will be a scar in the neck, and patients may experience neck tightness in the weeks after surgery due to scarring in deep tissues. We will give you instructions regarding wound care and neck management after surgery to minimize the effects of these and achieve the best cosmetic result.
Professor Sheahan is an expert high volume thyroid surgeon, having performed over 2,000 thyroid operations. Surgery is performed through the smallest incision possible. For many cases, this can be achieved through an incision <3.5-4cm. The outcomes of Professor Sheahan’s thyroid surgeries have been extensively audited and published. Among thyroid operations performed by Professor Sheahan using nerve monitoring, the risk of permanent injury to the recurrent laryngeal nerve is <0.5% (reference), the risk of haematoma is 1.3%, and the need for long term calcium supplementation after total thyroidectomy is 3.1% (reference). For thyroid publications authored by Professor Sheahan please click here: