ENT Thyroid Surgery And Other Treatments

What Is the Thyroid Gland?

The thyroid gland is a small butterfly-shaped gland located at the base of your neck, just below your Adam’s apple. It produces thyroid hormone, which helps regulate your body’s metabolism.
The thyroid gland regulates heart and digestive function, muscle control, brain development, mood, and bone mass.

Thyroid Conditions We Treat

Thyroid conditions encompass a range of disorders that impact hormone production and can affect health. The most common conditions include:

• Thyroid Dysfunction: an imbalance in hormone production
• Thyroid Nodules: umps or growths within the thyroid gland
• Goiter: an enlarged thyroid gland

Diagnosing thyroid conditions typically involves a combination of evaluating symptoms and medical history. Depending on your case, this could include conducting blood tests to measure hormone levels, performing imaging studies to assess the structure of the thyroid, and possibly conducting a biopsy if necessary.

Your doctor will determine whether treatment is required based on your diagnosis. At Northwest ENT and Allergy Center, we offer both surgical and non-surgical options for most thyroid disorders.

Thyroid Dysfunction

A thyroid dysfunction occurs when the thyroid gland does not produce the adequate amount of thyroid hormone. An overactive thyroid that produces too much hormone causes hyperthyroidism. An underactive thyroid that produces too little hormone causes hypothyroidism. Each dysfunction has different symptoms, but both require treatment to restore normal thyroid function and hormone levels.

Hyperthyroidism

Excessive production of thyroid hormone (hyperthyroidism) can cause:

• Excessive sweating
• Rapid heart rate/palpitations
• Tremors
• Weight loss
• Heat intolerance
• Nervousness, agitation, anxiety
• Hypothyroidism

Hypothyroidism

Conversely, an under-active thyroid gland (hypothyroidism) can result in:

• Fatigue
• Weight gain
• Cold intolerance
• Dry skin
• Muscle weakness
• Puffy face

Treatment for Thyroid Dysfunction

Hyperthyroidism Treatment

Hyperthyroidism can be treated in a number of ways. The choice of treatment depends on individual factors such as age, health status, and personal preferences.

• Antithyroid Medications are prescribed to reduce hormone production
• Radioactive iodine therapy is used to destroy overactive thyroid cells
• Surgery to remove port or all of the thyroid gland may be recommended if other treatments aren’t suitable or effective or if there’s a large goiter causing symptoms.
• Beta-blockers can help manage symptoms but do not address the underlying condition.

Hypothyroidism Treatment

The most common treatment for hypothyroidism is levothyroxine, a synthetic form of the thyroid hormone thyroxine (T4). It helps restore normal hormone levels in the body. The dosage is personalized based on factors like age, weight, and overall health. ENT thyroid specialists usually start patients on a low dose and gradually increase it while monitoring hormone levels through blood tests.

Patients typically need to take levothyroxine for life, with regular check-ups to ensure hormone levels remain stable.

Thyroid Nodules

Thyroid nodules are abnormal growths of thyroid cells that create lumps within the thyroid gland. Thyroid nodules are extremely common and may be solitary or multiple (multinodular goiter). They can be made up of normal thyroid tissue or can be cystic (fluid-filled). Most nodules (over 90%) are benign (noncancerous) and do not cause any symptoms.

In the following video, Northwest ENT’s Dr. Shatul Parikh explains how thyroid nodules are diagnosed and which nodules might warrant further examination.

A thyroid nodule is a growth in the thyroid gland. Thyroid nodules are extremely common and may be solitary or multiple (multinodular goiter).

Thyroid Treatment Options

If the size of the nodule causes trouble breathing or swallowing, surgery might be needed to alleviate these problems. If the nodule is suspected to be cancerous, surgery may be required to remove it and check it for cancer. Surgery is also an option when a nodule causes disfigurement (from a visible goiter), even if it’s not medically necessary.

Some non-surgical treatments can reduce the size of thyroid nodules. Nodules can also be removed through a thyroid surgery (thyroidectomy).

Endoscopic Thyroidectomy

Endoscopic thyroidectomy is a modern surgical technique used to remove the nodule through very small incisions, rather than the larger cuts typically required in traditional thyroid surgery. This procedure also has a faster recovery time.

An experienced surgeon works through an incision about one-third the size of a normal incision with the assistance of video cameras and slender instruments. Due to the specialized tools and approach involved, not all practices in the area offer this procedure.

Conventional Thyroidectomy

A conventional thyroidectomy can also be performed to remove a nodule. The extent of the operation depends upon the nature and extent of the pathology. During the surgery, the patient is typically placed under general anesthesia. The surgeon makes a small incision (cut) in the front of the neck, usually along a natural skin crease to minimize scarring.

If the thyroid nodules are large or complex, a conventional thyroidectomy might be preferred over an endoscopic procedure.

Ethanol Ablation of Thyroid Cysts

Some patients have large cystic (fluid-filled) nodules that can be treated with Ethanol Ablation rather than a thyroidectomy. Ethanol, which is similar to drinking alcohol, has been shown to permanently reduce the size of cystic nodules (often by more than 50%).

Ethanol ablation has been shown to have a low chance of the cyst returning after treatment. The procedure involves injecting the ethanol into the cyst space and takes about five minutes.

Northwest ENT and Allergy Center is one of the few ENT centers in the country that offer this treatment method for large cystic nodules.

Radiofrequency Ablation of Thyroid Nodules

Radiofrequency Ablation (RFA) is another non-surgical alternative to treat thyroid nodules. During the procedure, a thin needle-like electrode is inserted into the thyroid nodule under ultrasound guidance. Radiofrequency energy is then delivered through this electrode, generating heat that destroys the cells within the nodule. This process damages the tissue of the nodule and causes it to shrink.

RFA  is a 20-minute procedure performed under local anesthesia. Patients can expect to feel a similar level of pain or discomfort as they would after a regular thyroid needle biopsy. In most cases, patients can go home the same day and resume regular activity the day after.

Dr. Shatul Parikh explains how RFA works and why this procedure is a preferred approach to treat nodules. 

Goiter Surgery

A goiter refers to any abnormal swelling or enlargement of the thyroid gland. This swelling can be small or large and may appear as a noticeable lump in the neck.

Goiter can occur as a result of hypothyroidism, hyperthyroidism or thyroid nodules.  Hormonal changes during puberty, pregnancy, or menopause may also contribute to goiter development. Thyroiditis (inflammation of the thyroid gland) can also cause goiter. Certain medications, genetic factors, and even thyroid cancer (though rare) have also been associated with goiter.

While some goiters are small and cause no symptoms, larger goiters may lead to:

• A noticeable swelling in the neck
• Difficulty swallowing or breathing
• A feeling of tightness in the throat
• Hoarseness or changes in voice

While many goiters are harmless, they should be evaluated by a healthcare professional to determine if treatment is necessary. A large goiter can be surgically removed due to aesthetic reasons or because it is causing discomfort. Goiters can also be addressed by targeting the underlying condition that is causing the swelling.

 ENT Thyroid Specialist in Metro Atlanta, GA

At Northwest ENT, we can diagnose, treat and monitor thyroid conditions. We have five convenient locations to serve patients in the Metro Atlanta area. Book an appointment with an ENT thyroid specialist today.