Hi there! Thank you for your question. There are many causes of goiter (neck swelling) and hyperthyroidism (more thyroid hormones) is the most frequent cause. There are 3 management options for goiter, anti-thyroid medication, radioisotope ablation and surgery.

The choice of treatment will be determined by your doctor and it depends on the diagnosis, general condition of the patient and age. The three main drugs used are Carbimazole (the main drug used), Prophythiouracil and beta-blocker.

Radiation ablation is the use of radio-iodine to destroy thyroid tissue. This side effects are hypothyroidism and it can give rise to cancer risk (rare).
The two major types of thyroid surgery are total thyroidectomy (involves removing the entire thyroid gland) and sub-total thyroidectomy (involves removing about 8g thyroid gland).

This is done in the hope that abandoned thyroid tissue will be able to restore normal thyroid function. However, these tissues usually will not be able to restore normal function. Moreover, there is a greater possibility of goiter to reoccur again due to these waste tissues. Due to these reasons, surgeons do not like to make this surgery.

Thyroid gland surgery is performed for 4 reasons; cosmetics, cancer, anti-thyroid drug failure and compression of adjacent structures. Complications that may occur during surgery include injury to the surrounding nerves. There are 2 important nerves near the thyroid gland; "Superior laryngeal nerve" and "recurrent laryngeal nerve". Once the injury, "superior laryngeal nerve" produces husky voice and "recurrent laryngeal nerve" will produce hoarse voice.

Secondly, bleeding. This is because the thyroid is a very vascular organ, meaning it has a lot of blood vessels surrounding it. Thirdly, formation of "hematoma" (blood collection outside the blood vessels) - the patient will experience shortness of breath.

This happens because of the compression around the neck. However, all these complications can be avoided or mitigated through the proper preparation before surgery which your doctor will definitely do.

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