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THYROID AND PARATHYROID SURGERY
Thyroid nodules and goiters are common problems seen today. Many of these can harbor cancers within them. Thyroid nodules and enlarged thyroid glands require proper evaluation and treatment. When detected, they are usually referred for further work-up to an endocrinologist, or to an experienced head and neck surgeon. Following a thorough work-up, the patient may need to undergo thyroidectomy (removal of part or all of the thyroid gland) for several reasons — for removal of thyroid cancer, removal of part of the thyroid gland for definitive diagnosis, treatment of a hyperactive thyroid gland, or an enlarged thyroid gland that is causing breathing or swallowing difficulties.
Since thyroid cancers are highly curable, it is extremely important for the patient to undergo proper treatment and close follow-up. The initial treatment for most thyroid cancers is removal of the thyroid gland, and sometimes removal of lymph nodes which may contain metastatic cancer. In the hands of a highly-skilled, experienced surgeon, the procedure can be accomplished with a low risk of complications and a short, overnight hospital stay. Depending on the type of cancer, some patients may require treatment with radioactive iodine after surgery.
Our head and neck surgeons can perform minimally invasive thyroid surgery in selected patients. This new approach to thyroidectomy offers these patients attractive benefits, including less postoperative pain and a smaller scar, thus better cosmetic results.
Also essential is close follow-up by the patient's endocrinologist for tumor surveillance and regulation of the thyroid hormone. Our surgeons take a multidisciplinary approach to providing care for patients with thyroid and parathyroid disorders. The team of physicians consists of the surgeon, endocrinologists, radiation oncologists, radiologists, and pathologists. Management decisions are often made jointly among the team members. Such a team approach has ensured long-term successful outcomes for our patients at Stony Brook University Hospital.
Hyperthyroidism is a sustained overly active thyroid gland, which may result in anxiety, nervousness, rapid heartbeat, weight loss, and high blood pressure. The causes of hyperthyroidism include Grave's disease and toxic nodular goiter. This condition is treated with medications, radioactive iodine, or thyroidectomy (removal of the thyroid gland). The advantage of surgery is that the condition can be treated quickly and effectively, without recurrence. In the past, non-surgical treatment has been the primary approach to patient care because of potential complications associated with the surgery. Now, with surgical expertise and advances in technology at Stony Brook, more patients are undergoing surgery with minimal complications.
Hyperparathyroidism is a condition that causes high blood calcium levels. It is caused by the overproduction of parathyroid hormone (PTH) by the parathyroid gland(s). This chronic condition may result in kidney stones, osteoporosis, abdominal problems, fatigue, and depression, among other illnesses. It can successfully be treated by removing the abnormal parathyroid gland(s).
Minimally invasive parathyroid surgery can now be performed in ambulatory surgery setting, using local anesthesia, with minimal risk to the patient — see our Ambulatory Surgery Center. Preoperative imaging studies localize where the abnormal parathyroid gland is, thus enabling our head and neck specialists to perform minimally invasive surgery through a small incision. Furthermore, at Stony Brook, our special laboratory services allow us to recheck the PTH level while the patient is still in the operating room, just after the abnormal gland has been removed. This ability ensures that the operation has been effective and minimizes the potential need for reoperation.