saidatulnafisa

4 years

My 55 years old mother is scheduled for a thyroid surgery

Doctor, my 55 years old mother is scheduled for a thyroid surgery due to hyperthyroidism. I am quite relieved to know that once surgery is done she will be fine. However her surgery will be scheduled for the next 2 weeks and has additional medications to be taken instead. Why is that so? Is it true it’s to prevent an occurance known as thyroid storm?

Hi there! Thank you for your question. There are 2 types of thyroid surgeries total thyroidectomy (nvolves the whole thyroid gland) and sub-total thyroidectomy (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.

Just like any other surgery, there are possible complications of thyroid surgeries. Complications that can happen during the 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, Thyroid storm. This is a life threatening condition of hyperthyroid which often includes a rapid heartbeat, fever, and even fainting. This is rare and only occurs if the patient is inadequately prepared prior to the surgery. Complications that can happen after the surgery includes shortness of breath.

This happens due to accumulation of hematoma (collection of blood outside of blood vessels) 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.
As for your question, yes you will have to be on several meds during pre-op preparation.

This is to make sure the patient is euthyroid (having a normally functioning thyroid gland) in case of toxicity and end up with a thyroid storm post op. Firstly, Carbimazole. It is an anti-thyroid drug and is given 30-40mg per day until euthyroid. Secondly, beta-blocker to make patient euthyroid as well but works quicker than anti thyroid drugs. These drugs don’t stop hormone production, so if used alone there is still a risk of thyroid storm.

It is continued 7-10 days post op as a preventive measure. Thirdly, Lugols iodine. It is given 10 days before the surgery to reduce vascularity of the thyroid and make it more firm.

Please click on this link (DoctorOnCall) to talk to us privately online and discuss further about your inquiries. Thank you.

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