Home Chapter 2 ------------------ My Thyroid Surgery Entry # 11 - My Otolaryngologist (Ear, Nose and Throat Surgeon): The Right Place to Be
Entry # 11 - My Otolaryngologist (Ear, Nose and Throat Surgeon): The Right Place to Be
My Story - My Thyroid Surgery
Tuesday, 09 December 2008 17:00

The Otolaryngologist entered the room dressed professionally with confidence.  He was very friendly, kind, and polite.  My wife and I were very pleased with him.  He basically recommended surgically removing the nodule...

 

Unlike the first surgeon this surgeon answered all of my questions.  He told me exactly how many thyroidectomy surgeries he did last year (averaging 35-40 per month) and his complication rate, which was very low.  I believe it was less than 1%.

 

There are two serious complications that can happen from surgically removing one’s thyroid.  First, there is a risk of damaging the laryngeal nerve which can affect one’s voice box.  This can cause permanent changes or hoarseness in one’s voice.  This can be devastating for singers (which I’m not.)  Second, there is a risk of damaging the parathyroid glands which will require taking calcium supplements for the rest of one’s life.   The likelihood of these complications with this surgeon’s minimally invasive technique were extremely low.  

  

  

The surgeon, my wife and I discussed the surgical options.  I had a suspicious 2.8cm nodule on my left thyroid (suspicious for papillary carcinoma.)   These were the surgical options with the advantages and disadvantages of each.

 

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1.  Take out half the thyroid and wait for the final pathology report.

 

Advantage: If half the thyroid is taken out then one may not have to take thyroid hormone for the rest of their life.  A person can live a normal life with 70% of the time with only half a thyroid.  No risk of damaging all of one’s parathyroid glands.  There is a reduced risk to only damaging part of the laryngeal nerve.

 

Disadvantage:  If cancer is found then a second surgery has to be done to completely remove the entire thyroid.  One has to go back to surgery shortly after the first surgery.  Going through this extensive surgery once is hard enough.

 

2.  Take out half the thyroid and a frozen section pathology report will be conducted in the operating room while you are still in surgery.  If the frozen section is thyroid carcinoma the surgeon will take out the entire thyroid.  If the sample appears benign they will not take out the rest of the thyroid.  The final pathology report will still take 2 days.  The frozen section is only 70% accurate.

 

Advantage:  If the nodule is cancer then the entire thyroid can be taken out during the same surgery.   A second surgery will not have to be done.

 

Disadvantage:  The frozen section pathology results are only 70% accurate so the final pathology report can come back as non-cancerous or cancerous.   So one may still need a second surgery or the complete thyroid surgery could have been unnecessary.

 

3.  Take out the entire thyroid

 

Advantage:  A second surgery will not be necessary.   Pease of mind that entire thyroid has been removed.

 

Disadvantages: Risks of damaging all of parathyroid glands.  The patient would be required to take calcium supplements if all of the parathyroid glands get damaged.  Increase risks of damaging laryngeal nerve.  If the laryngeal nerve is damage one will get voice changes or hoariness.  The patient will have to take thyroid hormone medication for the rest of their life.

 

4.  Do nothing. Not recommended by the surgeon. This surgeon reported that there was a 60% chance that the suspicious nodule was papillary carcinoma.  The pathology department at MCG is very accurate with these reports.

 

Advantages: No surgery or thyroid hormone.

 

Disadvantages:  If the nodule is cancer then the longer it is in the body the more likely it can spread.  This decreases the chance for a success outcome and may decrease one’s life expectancy if the cancer progresses and metastasizes to other locations in the body.  The treatment may require more radiation to eradicated cancer.

 

After carefully weighing all options I elected to choose #1, just take out half of the thyroid and wait for pathology.  I tend to be conservative.  I scheduled the surgery in four weeks.  I’m going on a Christmas Caribbean cruise…..don’t want to have my neck sliced open before that!  Plus, I want to enjoy life a little before I get sliced open.

 

 

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