-Dr Vikram M. Bhardwaj


Thyroid gland is present in front of the neck in every individual and the function is secretions of all important thyroid hormones .A normal thyroid gland is neither visible nor palpable (felt with fingers) and has no nodules.

For a neck swelling suspected clinically to be thyroid swelling, three tests are needed – Thyroid profile (blood test) , Ultrasound Neck and FNAC (Needle test ).

In few cases , CT scan Neck may be required.

Depending on Ultrasound Characteristics and FNAC report , many times thyroid swellings are kept under observation with repeated tests after every 6 months. Sometimes, Hemi or Total Thyroidectomy is needed which is the surgery to remove half or entire thyroid gland.

During surgery, two structures are most important and should be preserved wherever possible. This is the technically challenging aspect of the surgery.

First is the recurrent laryngeal nerve which controls the vocal cords and hence determines quality of voice.  Second the parathyroid glands which control calcium metabolism.

Here we can see Recurrent laryngeal nerve along with inferior parathyroid gland and inferior thyroid artery in an intraoperative photograph of surgery done in 2018.

Patient is usually discharged in 2 days with normal diet. However advanced or neglected cases of thyroid swelllings can present more challenges with risk to airway/foodpipe and even chest extension.

So smaller the size of swelling, easier it is to manage. Bigger swellings need bigger scar and more chances of complications.

In selected cases, we remove the thyroid through axilla or oral cavity which have their own advantages and disadvantages.