Thyroid Gland Disorders
Ear, Nose and Throat (ENT) doctors are surgeons who operate in the head and neck region. The treatment of thyroid disorders, thus, is an integral part of our specialty.
Our specialists Dr. Jeffrey Zimmerman and Dr. Andrew Spector both provide surgical care for thyroid gland disorders. As Otolaryngoloists – Head and Neck surgeons both doctors have received extensive training exclusively in the head and neck region.
Dr. Zimmerman and Dr. Spector both trained at the Thyroid Treatment Center at Thomas Jefferson University and perform all thyroid surgery together. Surgery is performed using vocal cord monitoring which was first used in Manchester by Dr. Zimmerman upon is arrival to ENT Specialists of Southern New Hampshire in 2003.
Diseases of the thyroid gland are very common, affecting millions of Americans.
Common Thyroid Problems
Overactive Gland: also referred to as hyperthyroidism, e.g., Graves’ disease, toxic adenoma or toxic nodular goiter
Underactive Gland: also referred to as hypothyroidism, e.g., Hashimoto’s thyroiditis
Thyroid Enlargement: also referred to as a “goiter”, due to overactivity (as in Graves’ disease) or from under-activity (as in hypothyroidism
Patients with a family history or who had radiation therapy to the head or neck as children for acne, adenoids, or other reasons are more prone to develop thyroid malignancy.
Depending on the nature of your condition, treatment may include thyroid hormone replacement pills (for hypothyroidism); or medication to block the effects of excessive thyroid hormone production, radioactive iodine to destroy the thyroid gland, or surgical removal of the thyroid gland (for hyperthyroidism).
Goiters (lumps)
If you experience this condition, your doctor will propose a treatment plan based on the examination and your test results. He may recommend a fine needle aspiration biopsy which is a safe, relatively painless procedure. With this procedure, a hypodermic needle is passed into the lump, often after administration of local anesthesia into the skin, and tissue fluid samples containing cells are taken. Often several passes with the needle are required. Sometimes ultrasound may be used to guide the needle into the nodule. There is little pain afterward and very few complications from the procedure occur. This test gives the doctor more information on the nature of the lump in your thyroid gland and specifically may help to differentiate a benign from a malignant thyroid mass.
Thyroid surgery may be required when the fine needle aspiration is reported as suspicious or suggestive of cancer or the trachea (windpipe) or esophagus are compressed because both lobes are very large. Historically, some malignant thyroid nodules have shown a reduction in size with the administration of thyroid hormone. However, this treatment, known as medical “suppression” therapy, has proven to be an unreliable treatment method.
Thyroid Surgery
Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital, and general anesthesia is usually required. Typically the operation removes the lobe of the thyroid gland containing the lump and possibly the isthmus. A frozen section (an immediate microscopic reading) may or may not be used to determine if the rest of the thyroid gland should be removed.
Sometimes, based on the result of the frozen section, the surgeon may decide not to remove any additional thyroid tissue, or proceed to remove the entire thyroid gland, and/or other tissue in the neck. This is a decision usually made in the operating room by the surgeon, based on findings at the time of surgery. Your surgeon will discuss these options with you preoperatively.
There may be times when the definite microscopic answer cannot be determined until several days after surgery. If a malignancy is identified in this way, your surgeon may recommend that the remaining lobe of the thyroid be removed at a second procedure. If you have specific questions about thyroid surgery, ask your otolaryngologist and he will answer them in detail.
