Risks of Thyroid Surgery
In the hands of an experienced thyroid surgeon, thyroid surgery is a safe procedure with few complications. The main risks of thyroid surgery include:
Bleeding in the neck
As with any operation, there is always a chance of bleeding. The average blood loss for thyroid operations is usually small and the chance of needing a blood transfusion is extremely rare. However, bleeding in the neck is potentially life-threatening because as the blood pools, it can push on the windpipe or trachea causing difficulty breathing. Patients are observed overnight. If there is no sign of bleeding and the patient feels well, they will go home the next morning. Once at home, patients should watch for signs, such as difficulty breathing, a high squeaky voice, swelling in the neck that continues to enlarge, and a feeling that something bad is happening. If any of these symptoms happen, the patient should call 911 first and then their surgeon.
Hoarseness/Voice Change (recurrent laryngeal nerve injury)
There are two sets of nerves near the thyroid gland that help control the vocal cords. These are the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve. Damage to a recurrent laryngeal nerve can cause you to lose your voice or become hoarse. Temporary hoarseness, voice tiring, and weakness can occur when one or more of the nerves are irritated during the operation or because of inflammation that occurs after the surgery. This usually gets better within a few weeks, but can take up to 6 months to resolve. Even in the rare chance of having a permanently hoarse voice, there are things that can be done to improve voice quality. An otolaryngologist or Ear, Nose, & Throat specialist can be very helpful in determining the specific problem and can perform different procedures to help improve voice quality.
Hypocalcemia (low blood calcium levels) may occur after thyroid and parathyroid surgery because the parathyroid glands may not function normally right after surgery and temporary hypocalcemia/hypoparathyroidism is common. The parathyroid glands are four small, delicate glands that measure about the size of a grain of rice. They are located near, or attached to, the thyroid gland and control the blood calcium levels. Each thyroid lobe has two parathyroid glands. After thyroid surgery and before you are discharged home your blood calcium will be checked. You will also be sent home with instructions to take supplemental calcium for the first week or two weeks after thyroid surgery. Hypocalcemia can cause symptoms such as numbness and tingling (especially around the lips and in the hands and feet) as well as muscle cramps. At your first post-operative visit, your blood calcium level will be checked and you may be weaned off the supplemental calcium prescribed after your surgery. Only one half functioning parathyroid gland is needed for calcium control. If all four parathyroid glands were injured or removed during surgery, the blood calcium levels can become lower than normal.
Seromas are fluid collections underneath the skin at an incision site that feel like fullness or swelling. When minor, they get usually disappear within a few weeks. If the seroma is large, it may need to drained by a surgeon.
If a post-operative infection develops, drainage of the infected fluid may be needed and antibiotics may be necessary. The neck is a clean area and generally does not get infected.
For more information, please call our office at 410-328-6187.