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A guide to thyroid surgery in Singapore

Thyroid surgery, or thyroidectomy, is the removal of all or parts of your thyroid. This butterfly-shaped gland, located at the base of your neck, is responsible for producing hormones that regulate all aspects of cell metabolism, from how fast you burn calories to your heart rate. Problems of the thyroid are broadly classified into two groups — problems of hormone production (hyperthyroidism and hypothyroidism) and problems of nodular disease (lumps within the thyroid). 

Hyperthyroidism is the result of an overactive thyroid gland and involves symptoms like nervousness, excessive sweating and weight loss despite an increase in appetite. Hypothyroidism, on the other hand, is an underactive thyroid gland and comes with symptoms like lethargy, weight gain and depression. A goiter, a common representation of nodular disease, refers to the enlargement of the thyroid gland and may be linked to thyroid cancer. To treat these disorders, thyroid surgery is usually recommended. 

If you or a loved one has been advised to undergo thyroid surgery, here’s everything you need to know about the process, from risks to recovery.

What are the different types of thyroid surgery in Singapore?

There are a few types of thyroid surgery available in Singapore. Depending on certain factors including the condition of your thyroid and overall health, your doctor will recommend one that works best for you. They include: 

  • Hemithyroidectomy, or lobectomy. One lobe (half) of the thyroid is removed. This is usually recommended if a nodule or low-risk thyroid cancer occurs only to one side of the thyroid. 
  • Isthmusectomy. The isthmus, a piece of tissue that connects the two lobes of the thyroid, is removed. This is recommended for small tumours on the isthmus. 
  • Total thyroidectomy. The entire thyroid gland is removed. This typically happens for cases of thyroid cancer, bilateral thyroid nodules and Graves’ disease. 

What happens during and after thyroid surgery?

Thyroid surgeries in Singapore take place under general anaesthesia; you will be asleep and not feel any pain. Anaesthesia is administered either by breathing through a mask or injecting a liquid medicine into a vein. Following which, a breathing tube will be placed in your trachea to assist in breathing. During the surgery, your heart rate, blood pressure and and blood oxygen levels will be actively monitored. 

Often, a conventional thyroidectomy is performed, where a small incision is made in the center of your neck to directly access your thyroid gland. Otherwise, a transoral thyroidectomy takes place instead. This approach involves an incision inside the mouth instead of a neck incision. If you have thyroid cancer, the surgeon may also examine and remove lymph nodes around your thyroid. 

The surgery will take about two hours. After which, you’ll remain under observation for 24 to 48 hours and be well taken care of. You may experience neck pain and a hoarse or weak voice —  however, these symptoms are usually due to irritation from the breathing tube and are often temporary. Pain medication will be administered as needed, so don’t worry. There may be swelling and light bruising at the incision site several weeks after surgery, but this is normal and will resolve over time. Find out more about thyroid surgery here.

How can I prepare for thyroid surgery?

If you have hyperthyroidism, medication such as potassium and iodine solution will be prescribed to regulate your thyroid function and decrease the risk of bleeding. Apart from that, there is no need to go on a special diet or eliminate certain food groups. Just be mindful to avoid eating and drinking before the surgery, as with every operation that involves general anaesthesia.

Can I live a normal life after thyroid surgery?

Yes you can! After thyroid surgery, you’ll be able to resume everyday activities, including eating and drinking as per normal. However, it is advisable to wait 10 days to two weeks before engaging in strenuous sports and heavy lifting. Try not to go swimming or soak in a tub for at least a week too. Some patients —especially for those with their whole thyroid gland removed— may require lifelong thyroid hormone treatment, but nothing too drastic compared to life before surgery. 

As for the scar on your neck, it will take about a year from surgery to fade. During this time, your doctor may recommend using sunscreen to minimise the scar’s visibility. 

Are there any risks involved?

Thyroid surgery is generally a very safe procedure, but as with every surgery, it comes with its own set of risks as well. Some serious potential complications include: 

  • Bleeding right after surgery that could lead to acute respiratory distress
  • Infection 
  • Low parathyroid hormone levels (hypoparathyroidism) which can cause numbness, tingling or cramping due to low-blood calcium levels 
  • Permanent hoarse or weak voice 
  • Airway obstruction

These complications occur more frequently for patients who are undergoing a second thyroid surgery or those with extensive lymph node involvement. Otherwise, the risk of serious complications overall should be about 2%. However, we recommend communicating all concerns to your surgeon prior to surgery. If you have issues with your thyroid, consider visiting Dr. Dennis Chua.

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