Thyroid Surgery

Changes in the thyroid gland are common and can occur at any age. About one in three adults will develop a thyroid disease during their lifetime.
Different diagnosis of the changes
These can be hormonal changes, in the sense of hyperthyroidism or hypothyroidism, or structural changes, such as thyroid nodules or a general change in the size of the thyroid gland. Often there is a mixed form in which the structural changes of the thyroid gland can also lead to hormonal changes. If there is a suspicion of a thyroid disorder, the endocrinologist usually clarifies whether there is a hormonal and / or structural change by taking blood samples and using ultrasound. Some changes in the thyroid gland are also further clarified using scintigraphy, a special nuclear medical imaging technique. 
Indications for surgery
If there is a pronounced hyperthyroidism, e.g. in the context of Graves’ disease or thyroid autonomy, and the hyperthyroidism persists despite drug or nuclear medicine therapy, surgical therapy is usually necessary. We perform all thyroid operations through the smallest possible incision above the cervical fossa. If possible, we also make this incision disappear into a pre-existing neck fold in order to achieve a perfect cosmetic result. By using special, very small instruments, we operate in a way that is particularly gentle on the tissue.

Structural thyroid changes

Enlargement of the thyroid gland
Structural changes include thyroid nodules and changes in the size of the thyroid gland. A general increase in the size of the thyroid gland (struma diffusa) is caused in particular by iodine deficiency. Nowadays, very pronounced struma are rarely seen because iodine is supplied in the diet, e.g. in the form of iodised salt. However, if there is a pronounced goiter that persists despite medication or nuclear medicine therapy, there is usually an indication for surgical treatment.
Nodular changes in the thyroid gland
We diagnose nodular changes, the so-called struma nodosa, by means of ultrasound examinations. If there is an increase in the number or size of the nodules or if their hormonal activity is conspicuous, a further endocrinological or nuclear magnetic resonance examination is carried out first. Surgery may also be necessary in this case.

Changes in the thyroid gland are common and can occur at any age. About one in three adults will develop a thyroid disease during their lifetime.

Different diagnosis of the changes
These can be hormonal changes, in the sense of hyperthyroidism or hypothyroidism, or structural changes, such as thyroid nodules or a general change in the size of the thyroid gland. Often there is a mixed form in which the structural changes of the thyroid gland can also lead to hormonal changes. If there is a suspicion of a thyroid disorder, the endocrinologist usually clarifies whether there is a hormonal and / or structural change by taking blood samples and using ultrasound. Some changes in the thyroid gland are also detected by scintigraphy, a special nuclear imaging technique. In thyroid surgery, part of the thyroid gland or, depending on the findings, the entire thyroid gland is removed through a small incision above the pit of the neck. If possible, we also “hide” the access in a pre-existing neck fold in order to achieve a cosmetic result that suits you. The use of special, very small instruments allows us to perform operations that are particularly gentle on the tissue.

Hormonal thyroid changes

Hormonal changes in the thyroid gland can lead to hyperthyroidism or hypothyroidism.
Hypothyroidism (underactive thyroid)

Hypothyroidism (underactive thyroid gland)

Typical symptoms of hypothyroidism are physical fatigue, weight gain and hair loss. The hypothyroidism can be caused by an autoimmune disease such as Hashimoto’s thyroiditis. Diagnostically, endocrinological blood tests and ultrasound examinations are in the foreground here. In the case of persistent or relevant hypofunction, drug therapy is necessary, at least temporarily. Surgical therapy is usually not necessary.

Hyperthyroidism (overactive thyroid gland)

Hyperthyroidism often causes symptoms such as heart palpitations, weight loss and inner restlessness. These symptoms can also be similar to those of hypothyroidism. Hyperthyroidism is also diagnosed by endocrinological blood sampling, sonography and usually special nuclear imaging, the scintigram. Surgical therapy may be indicated if symptoms persist despite drug or nuclear medicine therapy.

Surgical spectrum for thyroid diseases

  • Complete removal of the thyroid gland (thyroidectomy)
  • Removal of half the thyroid gland (hemithyroidectomy)
  • Removal of a single or circumscribed thyroid lesion (enucleation)
  • Removal of lymph nodes in the case of cancer of the thyroid gland
RKM740 Dr. med. Nina Picker, und ihrem charmanten Lachen in ihrer Praxis porträtiert.

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