The thyroid is a very important gland that controls a wide array of important hormones and functions in the body. It plays a large role in the body’s metabolism, temperature control, digestion and even skin and hair health. It is located just below the skin and muscles of the front mid neck region. Disorders of the thyroid can include structural abnormalities such as nodules, cysts and tumors or conditions that affect the function of the thyroid and its hormones such as hypo or hyperthyroidism. Some cases are hereditary in origin or caused by environmental factors such as dietary deficiencies of iodine, exposure to radiation and side effects of medication. Some cases of thyroid conditions have no clear cause.
As an otolaryngology practice, we primarily address structural abnormalities of the thyroid that need surgical correction. Most tumors or nodules of the thyroid are noncancerous and may only require monitoring. They are extremely common and can be found in upwards of 4% – 7% of the general population in the United States. If the growths are large and cause pain, pressure or interfere with breathing and swallowing, surgery is indicated. For cancerous growths, a combination of surgery, chemotherapy and radiation may be required and is usually determined by a collaboration between oncologists (cancer specialists) and an ENT surgeon like Dr. Bailey.
Diagnosing thyroid abnormalities begins with a thorough history and physical exam in which your thyroid will gently be felt and examined. Some growths are palpable (easily felt) but others may lie on the back side of the thyroid where an examiner cannot feel. Whenever there is concern about an abnormality of the thyroid, a thyroid ultrasound, can be extremely helpful. An ultrasound can provide information on the size, shape, location and other structural characteristics of a thyroid tumor. Many small or fluid-filled masses are benign and as long as the thyroid is still functioning appropriately, frequent monitoring may be all that is necessary. Large masses and/or those with questionable characteristics will be further evaluated with a fine needle aspiration (FNA) which removes some tissue from the masse for further examination. The tissue is then examined under the microscope to help with the diagnosis.
Thyroid surgery is often considered when there is a suspicion or confirmation of cancer. Surgery may also be elected even if a lesion is noncancerous but is putting pressure on the other neck structures or interfering with swallowing or breathing. Sometimes the entire thyroid is removed but most of the time, the affected lesion and often the tissue immediately surrounding it is removed. Occasionally, more than one surgery is needed for complete removal of any tissue possible affected by cancer.