Post-thyroidectomy complications

Written by Luo Han Ying
Endocrinology
Updated on January 31, 2025
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In clinical practice, for large thyroid nodules that cause compressive symptoms, such as difficulty swallowing, breathlessness, and hoarseness, thyroid nodule excision surgery can be performed. However, this surgery can have sequelae. First, if the excised thyroid tissue is too large, it can easily lead to reduced thyroid function, requiring lifelong supplementation with thyroid hormones for treatment. Secondly, due to the sensitive location of the thyroid gland, which is surrounded by various glands and nerves, injury during surgery can lead to complications such as seizures and hoarseness, which are considered post-surgical sequelae.

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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.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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What should I eat for thyroid nodules to dissipate?

Traditional Chinese Medicine (TCM) believes that thyroid nodules are mainly caused by emotional distress, dietary imbalances, and environmental maladjustment. Long-term emotions such as anger and depression can lead to stagnation of qi (vital energy), resulting in liver qi dysfunction and the formation of phlegm. Qi stagnation and phlegm accumulation in the front of the neck lead to the formation of this goiter. Therefore, the treatment for this condition often involves the use of foods or medications that soften hardness, disperse nodules, reduce swelling, and resolve stasis. For example, purslane, loofah, plums, and dried figs are some of the foods that can clear heat, facilitate diuresis, reduce swelling, and disperse nodules. Appropriate consumption of these foods can be beneficial in slowing the progression of the disease. However, it is generally difficult to dissolve nodules through diet alone, and active treatment is still necessary.

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Written by Liang Yin
Endocrinology
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Can thyroid nodules be detected?

Some thyroid nodules can be observed through visual inspection, while others cannot be seen as they vary in size, and most are very small. These nodules are often discovered during medical check-ups, specifically through ultrasonic imaging of the thyroid. Unless a thyroid nodule is particularly large, or grows outward prominently on the front surface of the neck, it can be visibly detected in a clinical setting. Thyroid nodules are quite common in thyroid diseases, and most are benign and do not require treatment, only regular follow-up examinations.

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Written by Li Jin Quan
General Surgery
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Thyroid nodule calcification meaning

In our thyroid ultrasound, terms like thyroid nodule calcification are often seen. Thyroid nodule calcification is a form of self-healing. It can be divided into large and small nodule calcifications. Generally, large nodule calcifications have a very low proportion of malignancy. The possibility of malignancy in smaller calcifications is relatively higher. When we see a report indicating thyroid nodule calcification, there is no need to panic. We can consult specialists such as thyroid surgeons, who will tell you how to distinguish between benign and malignant conditions. I recommend performing thyroid cytological puncture, which, through pathological examination, can determine whether the thyroid nodule calcification is benign or malignant.

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Written by Luo Juan
Endocrinology
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Can thyroid nodules be treated?

It depends on the situation. For some patients, we can evaluate whether thyroid nodules are accompanied by changes in thyroid function. If there is an overactive thyroid, antithyroid treatment is necessary. If there is underactive thyroid function, appropriate thyroid hormone supplementation is needed, and some patients' nodules can shrink. Additionally, for some thyroid nodules, if there are no accompanying changes in thyroid function, and the nodules are assessed as benign through ultrasound and other evaluations, no special treatment is generally needed. It is recommended to monitor thyroid ultrasound and function every six months to a year. Furthermore, if some thyroid nodules grow rapidly or there is a potential for cancerous changes, or if there are significant compressive symptoms, we can also perform a fine needle aspiration biopsy of the thyroid cells, or surgical treatment. Therefore, whether thyroid nodules can be treated also depends on the situation.