Possible Impact of Thyroid and Parathyroid Surgery

Parathyroidectomy patient - 60 years old

Patient Feedback

Parathyroidectomy patient - 60 years old

I feel so much better now. I wish all patients with hyperparathyroidism could be diagnosed and operated on as quickly as my experience. It is a dreadful disease that impacts people's bodies and lives in so many negative and frightening ways.

I chose due to his knowledge of hyperparathyroidism and experience of performing parathyroidectomies.

I was pleased with the quick and thorough diagnosis and how smoothly all scans and tests were done. Mr Kirkby-Bott was caring and his secretary was efficient and pleasant. The operation was as I expected and the scar healed well and is fading nicely.

- Voice Change - Low calcium - Bleeding

1.Voice Change

Voice change can effect up to 20% of patients of which 90% is temporary

By temporary I mean it gets better within 6 months.

For around 2% of patients having endocrine surgery the voice change is permanent. In these cases referral to a specialist voice surgeon and speech therapist to discuss options to improve the voice can help.

We take every effort possible to find and protect the recurrent laryngeal nerve during these operations to help protect it. Occasionally, unfortunately this surgery can change your voice quality and strength.

Usually it is due to damage to a nerve running just under the thyroid gland to the voice box. It can make the voice weak and difficult to project. It will also tire quicker than usual so that towards the end of your day it can be harder to speak audibly.

If this has happened to you it is useful to visualize this injury as if you have injured a muscle. When first healing, it likes some rest and then it likes to have activity re-introduced and built up gradually. Follow the same principle for your voice.

In addition to voice change recurrent laryngeal nerve injury can make swallowing feel abnormal. In the very very rare event of both recurrent laryngeal nerves being injured more severe disability can be caused - weaker voice, difficulty swallowing safely and even difficulty breathing requiring a tracheostomy. Remember this is exceptionally rare because such care is taken to protect this nerve. Bilateral nerve injury can only occur after a total thyroidectomy or bilateral neck exploration for parathyroid disease.

If you are affected by this complication please try these voice strengthen exercises when you feel ready to help strengthen your voice again

Why does low calcium happen?

2. Low Calcium

This happens because the 4 glands controlling calcium levels in the blood are attached to the thyroid gland and have to be carefully dissected off during thyroidectomy. They are very small. A normal gland is 6x4x2mm in size so their blood supply is very delicate. Normal function of 1 of these 4 glands is enough to maintain normal calcium levels. It is fairly common after total thyroidectomy or completion thyroidectomy for the glands to be bruised and not work normally for a few weeks, this can affect up to 20% of patients.

Permanent damage is rare and affects about 1% of patients.

Advice on medication, how to take it and how to maintain calcium levels

Why do I recommend that you stay overnight?

3. Bleeding

This complication is rare but important. It is why we advise everyone having thyroid surgery to stay in hospital the night after surgery. In around 1 in 500 cases an urgent return to theatre is necessary to remove any blood clot and re-examine the surgical site.

Click here for The British Association of Endocrine & Thyroid Surgeons (BAETS) patient information leaflets

All of Mr Kirkby-Bott's outcomes are recorded on a National Database of Endocrine surgery outcomes run by the British Association of Endocrine and Thyroid Surgery (BAETS)

Click here to see Mr Kirkby-Bott's outcomes reported on national database

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