Your thyroid gland is an endocrine gland that makes hormones to regulate multiple functions in your body-- like metabolism, temperature regulation, and keeps your muscles and organs working properly. The thyroid gland is located in the middle of the lower neck, below the voice box and wraps around the front half of the windpipe. It is shaped like a butterfly, having two halves (lobes) joined by a small tissue bar (isthmus). You can't always feel a normal thyroid gland.
What is a thyroid disorder?
There are many different types of thyroid diseases. Diseases of the thyroid gland are very common, affecting millions of Americans. The most common thyroid problems are underactive glands (hypothyroidism), overactive glands (hyperthyroidism), thyroid enlargement (goiter), thyroid nodules, and thyroid cancers. Ear, nose and throat (ENT) specialists perform surgery to treat thyroid nodules, thyroid enlargement and thyroid cancer.
What are Thyroid nodules?
Thyroid nodules are very common. A nodule is an area of abnormal growth within the thyroid gland. Some people have a single nodule while others have multiple nodules within the gland. Thyroid nodules are particularly common in women but occur in men as well. They can be tiny to very large. Most thyroid nodules are benign (non-cancerous), do not cause symptoms and do not need any treatment. However, in some cases the nodule may need further evaluation or treatment.
Your doctor may recommend an ultrasound to determine the size, location, as well as whether the nodule is solid or filled with fluid (cystic).
A needle biopsy (known as an FNA—fine needle aspiration) may also be recommended to sample the nodule. An FNA is a procedure where a small needle is inserted into the nodule and some of the cells from the thyroid nodule are pulled back into a syringe to be evaluated under the microscope by a pathologist. This is most commonly performed using an ultrasound to assist with accurate sampling of the nodule.
Thyroid surgery may be recommended if the nodule (s) is found to contain cancer or suspicious of cancer.
What is Thyroid Cancer?
Thyroid cancer is very common, particularly in women. It is now one of the most common cancers found in women. Most forms of thyroid cancer are slow growing and are well-treated with surgery. Thyroid cancers generally are found within thyroid nodules. Many patients with thyroid cancer do not report any symptoms at all, though they may report a lump in the neck, difficulty swallowing, and/or voice changes.
There are several types of thyroid cancer including:
Papillary—This is the most common form of thyroid cancer. This type of cancer, which tends to grow slowly, has a good prognosis. It can spread to neck lymph nodes.
Follicular—This type of thyroid cancer also typically has a good overall prognosis except when significant invasion of other tissues is present.
Medullary—This form of thyroid cancer develops from cells in the thyroid gland that are different from papillary and follicular thyroid cancers. While the prognosis with medullary cancer is not as favorable when compared with those types of thyroid cancers, it is also much less common (between five- and 10-percent of all thyroid cancers). While medullary thyroid carcinoma can be associated with several inherited syndromes, more often it occurs in patients without any family history.
Anaplastic—This is the least common type of thyroid cancer, but it is very aggressive, and the prognosis is poor. It presents as a rapidly enlarging neck mass.
The primary treatment for thyroid cancer is surgery. Surgery involves removing the thyroid gland and sometimes enlarged lymph nodes. Surgical treatment is determined on a case-by-case basis and is determined by the patient’s biopsy, nodule size, and other factors.
What is a Goiter?
A goiter is enlargement of the thyroid gland. The thyroid may be filled with multiple nodules. A goiter can be seen or felt as a lump in your neck. As goiters become bigger they can put pressure on your windpipe or esophagus. This can cause a choking sensation, pressure in the neck, difficulty swallowing or breathing. In some parts of the world, goiters develop because of a lack of iodine in peoples’ diets. However, in the United States where iodine is added to salt, goiters are most often caused by other problems. A family history of goiter increases the risk of developing goiter. If you experience a goiter, your doctor may recommend an ultrasound to determine the size of the gland and any nodules, a needle biopsy (FNA) to sample some of the nodules, or thyroid surgery. Thyroid surgery may be recommended if the goiter is compressing the windpipe or esophagus, or if the needle biopsy is suspicious or suggestive of cancer.
What is thyroid surgery?
Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed under general anesthesia. Typically, the operation removes the entire half of the thyroid gland containing the lump and possibly the isthmus. 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. As an alternative, your surgeon may choose to remove only one lobe and await the final pathology report before deciding if the remaining lobe needs to be removed. There may be times when the definite answer cannot be determined until several days after surgery. If a cancer is identified in this way, your surgeon may recommend that the remaining lobe of the thyroid be removed.