Diseases of the thyroid glands are common – It is estimated 1 in 20 patients will have a thyroid nodule that is palpable.
Thyroid nodules are approximately more common in women than in men.
Most thyroid nodules are benign and an accurate assessment will usually require an ultrasound scan and a needle biopsy along with a thyroid function test.
There are several surgical approaches to remove a thyroid lump.
The conventional way usually involves a skin crease incision along the anterior aspect of the neck to access the lump. This scar usually heals well if proper precautions are taken perioperatively.
Minimally Invasive Video Assisted Thyroid Surgery (MIVAT)
Several minimally invasive approaches exist to remove the lump. An example of a minimally invasive video assisted thyroid surgery is shown below.
There are several other approaches available including robotic thyroid surgery and even transoral thyroid surgery. A thorough evaluation will be necessary to decide on the best approaches for the patient.
Patient safety is of utmost importance and complete removal of a suspected thyroid cancer with clear margins is the priority in choosing the appropriate surgical approach. The American Thyroid Association guidelines is very useful in directing the management of patients with thyroid nodules.
Article in Business Times : 3rd December 2016
Lumps in the neck are common and the cause is usually benign. However, the lump may be the presentation of more serious disease, eg malignancy or chronic infection and so a thorough assessment and diagnosis are essential. If there is any doubt as to the cause, then the patient should be investigated further either with imaging or a needle biopsy. Patients over the age of 40 are more likely to have a neoplastic cause. Inflammatory, congenital and traumatic causes are more common in younger patients but neoplasm should still be borne in mind.
Investigations that may be helpful to evaluate a neck lump:
Sialoendoscopy is a minimally invasive technique that allows for salivary gland surgery for the safe and effective treatment of obstructive salivary gland disorders (eg stones) and other conditions of the salivary glands. During sialoendoscopy a small endoscope is placed into the salivary glands through the salivary ducts that empty into the mouth. Sialoendoscopy is an efficient yet simple mode of treatment for major salivary gland obstructions, strictures and sialoliths(salivary stones).
There are around 300 lymph nodes in the head and neck region. Most cannot be felt unless they are enlarged. 95% of causes of enlargement are benign and are usually due to an upper respiratory tract infection. 5% of the time we worry about malignancy (cancer) or tuberculosis.
A thyroglossal duct cyst is a pocket in the front part of neck that is filled with fluid. A child is born with this cyst. It is formed from leftover tissue from the development of the thyroid gland when an embryo was forming. The thyroid gland is located in the front of the neck. This has to be investigated frequently with imaging (either ultrasound scan or CT scan) to visualise the location and to ensure it is not the only source of thyroid hormone production in the body. Also a fine needle aspiration cytology can be performed to ensure there is no malignancy.