Effects after thyroid nodule removal

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 13, 2024
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Thyroid surgery often leads to postoperative bleeding as a common complication. Bleeding may compress the trachea, causing difficulty in breathing. If a patient exhibits severe breathing difficulties along with significant bleeding from the drainage tube post-surgery, emergency hemostasis should be performed. Secondly, tracheomalacia. Long-term compression from the mass softens the tracheal wall, leading to a collapse due to inadequate support from surrounding tissues. Thus, after removing thyroid nodules, the thyroid and adjacent tissues fail to support the softened trachea, resulting in breathing difficulties. Thirdly, pharyngeal edema. During surgery, inflammatory stimulation can cause edema in the surrounding tissues, which may lead to difficulty in breathing. Therefore, after ruling out possibilities of postoperative bleeding, tracheomalacia, or vocal cord paralysis, pharyngeal edema should be considered. Nebulization therapy can be administered. Fourthly, vocal cord paralysis is common due to accidental damage to the recurrent laryngeal nerve during surgery, causing hoarseness. Generally, patients may gradually recover over three to six months, and symptoms can improve. The fifth effect is damage to the parathyroid glands. If the parathyroid glands are damaged, it may lead to abnormal blood calcium levels and symptoms of hypocalcemia, such as tetany and spasms. Most cases are due to vascular damage to the parathyroid glands resulting in temporary hypofunction, which often recovers shortly. The sixth possible outcome is a thyroid storm. Some patients with hyperthyroidism may experience a sudden release of large amounts of thyroid hormone into the bloodstream post-surgery, causing high fever, irregular heart rate, restlessness, nausea, vomiting, coma, and even death. The seventh effect is that removal of the thyroid gland leads to a deficiency in thyroid hormones, resulting in symptoms of hypothyroidism.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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What is a thyroid nodule?

The thyroid is an endocrine gland located in the neck of the human body. If some abnormal nodules appear in it, they are referred to as thyroid nodules. Based on histological classification, they can be divided into follicular type, papillary type, and mixed type. A common characteristic of these types is that they generally appear as solitary nodules with a relatively complete capsule; the tumor cells differ from the surrounding thyroid tissue; and the cellular structure inside the tumor is relatively consistent. Generally speaking, middle-aged women are the demographic most prone to developing thyroid nodules.

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Written by Lin Xiang Dong
Endocrinology
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Where to do acupuncture for thyroid nodules?

Thyroid nodules do not require acupuncture treatment. The vast majority of thyroid nodules are benign, with only a small portion, about 5%, being malignant. We generally determine the treatment approach based on whether the nodule is benign or malignant. For benign nodules, we typically follow up with observation, while malignant nodules require surgical treatment and oral medication, or Iodine-131 radiotherapy. The primary evaluation for distinguishing between benign and malignant nodules relies on the results of color Doppler ultrasound and the pathology results from thyroid fine-needle aspiration.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Should thyroid nodules be punctured?

Thyroid fine needle aspiration is a reliable and highly valuable diagnostic method we use to distinguish between benign and malignant thyroid nodules. Generally, thyroid nodules with a diameter >1 cm are considered for fine needle aspiration. Fine needle aspiration is not routinely considered in the following situations: (1) The nodule has already been evaluated with a nuclear scan indicating a hyperfunctioning adenoma due to hyperthyroidism; (2) The nodule is purely cystic; (3) The nodule is highly suspected to be highly malignant. In cases where the nodules grow rapidly and significantly enlarge, causing compression of the surrounding trachea and symptoms such as breathing difficulties and hoarseness, these thyroid nodules requiring surgery do not necessitate further fine needle aspiration treatment.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Are thyroid nodules serious?

The severity of thyroid nodules needs to be assessed based on their nature, size, function, and location. Generally, they can be classified into benign and malignant, with malignant nodules being thyroid cancer, which requires timely treatment. Surgical treatment is the main method for treating thyroid cancer, whereas most benign nodules do not require special handling. Regarding the size of the thyroid nodules, if the nodules are too large and compress surrounding tissues such as the trachea, esophagus, and nerves, surgical treatment is recommended. For common benign nodules, regular observation is sufficient. Functionally, some thyroid nodules may affect thyroid function, such as in Hashimoto's thyroiditis, which can present with diffuse multiple nodules, leading to either hyperthyroidism or hypothyroidism. In such cases, appropriate medication treatment is needed. From a positional perspective, ectopic growth of thyroid nodules, if located at areas like the base of the ear, pharynx, neck, esophagus, or thoracic cavity, is a rare congenital developmental anomaly. If such a nodule significantly enlarges and compresses surrounding tissues, surgical treatment is advised.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid nodule examination checks what

Generally, when thyroid nodules are detected, one should visit the hospital's breast and thyroid surgery department or the endocrinology department. If you find a thyroid nodule, you can consult a doctor and undergo some relevant tests based on your specific situation. Typically, the following tests are conducted: 1. Thyroid ultrasound: This can determine the size, number, location, texture, shape, and edges of the nodules, including whether there is calcification. It also examines the blood supply within the thyroid nodule, the relationship with surrounding tissues, and assesses whether there are lymph nodes in the neck and the nature of these lymph nodes. 2. Blood tests are needed to measure thyroid function, particularly the level of Thyroid Stimulating Hormone (TSH). Higher levels of TSH indicate that the thyroid nodule is more likely to be proliferative, and thus, the risk of thyroid cancer increases. In addition, Thyroglobulin (Tg) can be measured. Another measure is Serum Calcitonin (Ct). If serum calcitonin is > 100 pg/mL, medullary thyroid cancer should be highly considered, as these cancer cells can secrete large amounts of serum calcitonin, causing this marker to significantly increase. Nuclear isotope imaging is also performed. If the nodule is large and TSH levels are low, a thyroid radionuclide scan is conducted to see if the nodule is a hyperfunctioning adenoma. When necessary, a Fine Needle Aspiration Biopsy (FNAB) is also performed. Fine needle aspiration is an invasive test, but it is currently an important and most efficient method to assess the benign or malignant nature of the nodule. It is generally performed under ultrasound guidance.