Operation
During thyroid gland surgery, the patient is always put under general anesthesia, regardless of whether only the nodule or whole parts are removed. Accurate work is also of utmost importance here. In order to reach the operating area, the incision is made across the neck at half length.
For later cosmetic reasons, an incision in a skin fold is often used. Due to this localization, the scar is often hardly visible after complete healing. The uppermost skin layer is followed by the lower layers, the connective tissue and the neck muscles.
The thyroid gland rests on the larynx and must now be carefully removed. Due to the good vascular supply with which the organ is equipped, the surgeon should expect bleeding at any time and be prepared for it by hemostatic measures. Special complications can occur during thyroid surgery.
As a rule, the larynx or the windpipe is not injured, as this would require very rough handling. Special attention must be paid to the parathyroid glands, including epithelial corpuscles. These are arranged in pairs one above the other, behind each thyroid lobe and are important for calcium metabolism.
They produce parathormone, which can increase the calcium level in the blood. Since the epithelial corpuscles are very small, there is a risk that they will be removed as well. If not enough tissue can be left in the surgical area, there is another option for preservation.
In this case, the parathyroid glands are relocated into the arm and connected to the vascular system, so that the calcium balance can continue to be regulated. In addition to these smallest organs, the laryngeal recurrent nerve must be taken into account. In its course it passes the thyroid gland and finally reaches the larynx, located on the side of the trachea.
There it is responsible for the nerval supply of almost all laryngeal muscles, which shows its immense importance. Damage to the laryngeal recurrent nerve can lead to permanent damage. This can manifest itself in the form of permanent hoarseness or shortness of breath.
Damage to both sides is problematic. Since the muscles of the larynx as well as the vocal cords can no longer be moved, the opening of the glottis becomes impossible – the patient threatens to suffocate.