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Pediatrics | Adults | Thyroid | Salivary Glands | Voice/Vocal/Speech/Language | Head/Neck | Coblation Tonsillectomy

Thyroid Surgery and Glandular Surgery

The thyroid gland produces hormones that are used by the body to regulate an individual’s metabolism. In some patients, their thyroid problem may require a partial or full removal of their thyroid gland. Hyperthyroidism will normally respond to medications but an ENT doctor may use radioactive iodine or throat surgery for pediatric and adult patients. When an enlarged thyroid gland (goiter) causes problems breathing or swallowing, an ENT doctor may perform throat surgery. Thyroid cancer or cancerous thyroid nodules typically require throat surgery as a corrective procedure.

Hypothyroidism Symptoms

Common symptoms due to low thyroid or hypothyroidism are:

  • Fatigue and weakness
  • Low basal temperature (cold intolerance)
  • Dry and coarse skin
  • Hair loss
  • Cold hands and feet
  • Weight gain
  • Insomnia
  • Constipation
  • Depression
  • Poor memory, forgetfulness, dementia
  • Nervousness and tremors
  • Immune system problems
  • Heavy menstrual periods

Thyroid problems:

A. Patients most commonly are referred to the ENT doctor for thyroid problems because they have a lump in their neck or a nodule found on a thyroid ultrasound.

B. Causes: cancer, over-active nodule, non-functioning nodule, immune system problems (autoimmune disorders), developmental problems (i.e. thyroglossal duct cyst), genetic condition.

A partial or complete removal of the thyroid gland is a very common ENT procedure that is performed to correct a variety of thyroid gland abnormalities. Your ENT doctor will often work closely with endocrinologist to determine the underlying cause and severity of your particular problem. One of the most common neck surgeries involves a needle-aspiration biopsy of swollen thyroid nodules, removal of the goiter and partial or total surgical elimination of the thyroid gland. Although many patients only think of an ENT doctor as a surgeon, most ENT problems of the head and neck can be resolved using medications or other medical intervention.

Parathyroid problems:

A. Symptoms: Since parathyroid disease (hyper-parathyroid disease) was first discovered in 1925, the symptoms have become known as "moans, groans, stones, and bones" with psychic overtones.

Patients often simply do not feel well, have loss of energy, feel old, cannot concentrate, have loss of sex drive, often have kidney stones, are often depressed, are irritable, and may have heart palpitations, thinning hair, hurting bones, acid reflux, or recurrent headaches. Blood tests can reveal an abnormally high calcium level. Hypo-parathyroid disease is rare and almost always caused by surgery to remove the thyroid or parathyroid glands. The symptoms are usually numbness, tingling, cramps, and irregular heartbeat. Patients are most commonly referred to the ENT doctor for parathyroid problems because of a lab test that shows abnormal blood calcium and abnormal blood parathyroid hormone level.

Hyperthyroidism Symptoms

Common symptoms due to low thyroid or hyperthyroidism are:

  • Fatigue and weakness
  • Heat intolerance
  • Dry and coarse skin, clammy skin
  • Hair loss
  • Warm hands and feet
  • Weight loss
  • Insomnia
  • Depression
  • Poor memory, forgetfulness
  • Nervousness and tremors
  • Immune system problems
  • Light menstrual periods
  • Frequent defecation

B. Causes: Surgery (99%), inability of the kidneys and bones to respond to parathyroid hormone (extremely rare), and inability of parathyroid gland to make active form of hormone (extremely rare).

Problems with nerves and blood vessels:

There are many important nerves in the face and throat that are treated by ENT physicians. These nerves have very interesting names but can best be remembered by the symptoms they cause: damage to the facial nerve causes the muscles of the face to become weak (often called Bell’s Palsy), weakness of the laryngeal nerve causes a hoarse voice, problems with the hypoglossal nerve results in decreased tongue movement, weakness of the spinal accessory nerve makes it difficult to lift the shoulder, damage to the lingual or corda-tympani nerves will alter the way food tastes, damage to the olfactory nerve will cause an impairment in the ability to smell and taste.

The blood vessels in the neck and ear can develop non-cancerous tumors called "Paragangliomas". The symptoms associated with these tumors include neck swelling and nerve weakness as described above. When the tumor forms in the ear, patients will often complain of hearing a pulse or heartbeat in the ear. Tumors that arise in the blood vessels of the head and neck are rare but serious and need immediate medical attention.