More than 30 million Americans suffer from a thyroid disorder, and many more go undiagnosed every year. Now is a good time to become aware of your thyroid and its relationship to your health — and how best to take care of it.
Thyroid nodules and enlarged thyroid glands are common problems, and they can harbor cancers within them. They require proper evaluation and treatment.
When detected, patients with these thyroid disorders are usually referred for further work-up to an endocrinologist, or to an experienced head and neck surgeon, like one of the head and neck surgeons at Stony Brook Medicine.
January is national Thyroid Awareness Month that aims to bring to the public's attention the need to take good care of this important tiny gland in the neck.
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.
The thyroid gland is a small, butterfly-shaped gland located in the base of the neck just below the Adam's apple. Although relatively small, the thyroid gland influences the function of many of the body’s most important organs, including the heart, brain, liver, kidneys, and skin. Ensuring that the thyroid gland is healthy and functioning properly is important to the body's overall well-being.
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 thyroid specialists, Mark F. Marzouk, MD, Elliot Regenbogen, MD, and Ghassan J. Samara, MD, perform minimally invasive thyroid surgery in selected patients. This leading-edge approach to thyroidectomy offers these patients attractive benefits, including less postoperative pain, faster recovery, 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 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.Role of Surgery in Treating Thyroid Disorders
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 Medicine, more patients are undergoing surgery with minimal complications.
Thyroidectomy is performed for nodules and cancer of the thyroid gland. It is also performed in some patients with overactive thyroid glands.
Compared with conventional thyroidectomy, MIVAT offers patients attractive benefits, including less postoperative pain, faster recovery, and a smaller scar, thus better cosmetic results.
Traditionally, the procedure is performed through an incision that is about 3-3½ inches in the lower neck. Minimally invasive video-assisted thyroidectomy (MIVAT) is a relatively new approach. It was first perfomed in 1998. With this technique, thyroidectomy is performed through a much smaller incision, usually 1-2 inches.
MIVAT is an adaptation of the established minimally invasive laparoscopic procedures in which similar instrumentation, such as a long narrow telescope attached to a videocamera system, is used to enhance visualization, and special long narrow instruments that grab, cauterize, and cut tissues facilitate dissection through a small incision.
Studies have shown that MIVAT can be safely performed with minimal complication rates, no different from those of conventional thyroidectomy. MIVAT is not appropriate for everyone, and careful patient selection is very important for successful outcome.