Answered by: Dr Ramzdhan
Hi doctor, I have hyperthyroid and my neck is swollen because of goitre. I feel so embarrased becauseof that. I have been isolating myself and so withdrawn from others. Please help me. I want this swelling to dissappear.
Hi there! Thank you for your question. There are 3 management options for a goiter. They are antithyroid drugs, radioisotope ablation and surgery. Choice of treatment depends on the diagnosis, general condition of patient and age.
Three major drug that are used. Firstly, Carbimazole (the main drug that is used). It reduces the production of thyroid hormones. Symptoms will improve between 2-6 weeks. Like every other drug, it has side effects. They include rashes, anaemia, fever, and nerve damage. Secondly, Prophythiouracil – the main drug used during pregnancy due it carries less risk to the baby. Thirdly, beta-blocker
Radioisotope ablation is the ingestion of radio-iodine to destroy the thyroid tissue. The side effect is hypothyroidism and there is an increased risk of cancer (rare).
The 2 main types of thyroid surgeries are total thyroidectomy (it involves the whole thyroid gland) and sub-total thyroidectomy-(it involves removing about 8g of the thyroid gland).
This is done in hopes that the left over thyroid tissue will be able to restore normal thyroid function. However, most often the left over tissue will not be able to restore normal function. Moreover, there will be higher chance of reoccurrence due to the leftover tissue. Due to these reasons, surgeon don’t prefer them. Thyroid surgeries are done for 4 reasons; cosmetic, cancer, failure of anti-thyroid drugs, and compression of nearby structures.
Possible complications during surgery includes injury to surrounding nerves. There are 2 important nerves near the thyroid gland; superior laryngeal nerve and recurrent laryngeal nerve. Once injured, the superior laryngeal nerve will produce a husky voice and the recurrent laryngeal nerve will produce hoarseness of the voice.
Secondly, bleeding. This is because the thyroid is a highly vascular organ, mean it has a lot of blood vessels. Thirdly, hematoma formation (collection of blood outside of blood vessels) – patient will have shortness of breath. This happens due to compression around the neck. Nevertheless, all these complications can be avoided or reduced through proper preparation before the surgery which will be done by your doctor.
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