Thyroid + Parathyroid
Puget Sound ENT customizes thyroid treatments for every individual.
Our surgeons provide comprehensive evaluation and treatment of patients suffering from thyroid and parathyroid disease. We use the latest imaging technologies including CT parathyroid scans and ultrasound for quick assessment of thyroid and parathyroid conditions to determine the need for surgical intervention. We work closely with a multidisciplinary team consisting of oncologists, endocrinologist, and radiologists to ensure the best possible treatments and outcome. If surgery is recommended, we utilize state of the art techniques for the removal of the thyroid or parathyroid glands. In most cases, these are done in the outpatient setting, without the need for hospitalization.
THYROID
The thyroid is a butterfly-shaped gland in the middle of the neck, located below the larynx (voice box). It produces hormones, T3 and T4, which regulate multiple functions of the body including hair, nails, weight, energy, temperature and cognition. There are a number of conditions that can affect the thyroid gland. Overproduction of thyroid hormone results in a condition called Hyperthyroidism. Conversely, low thyroid hormone production leads to Hypothyroidism. Dysregulation of thyroid hormone production is managed by an endocrinologist.
Thyroid glands can also develop lumps or nodules. The term thyroid nodule refers to any abnormal growth of thyroid cells in a lump within the thyroid. Thyroid nodules are very common. Up to half of all people have at least one thyroid nodule, although most do not know about it. We do not know what causes most noncancerous thyroid nodules to form. 9 out of 10 nodules are benign (noncancerous) Most thyroid nodules do not cause any symptoms. Your doctor usually discovers them during a routine physical examination or you might notice a lump in your neck while looking in a mirror. If the nodule is large, it may cause difficulty swallowing, “tickle in the throat” or shortness of breath if it is pressing on the windpipe. Rarely, hoarseness of voice can be caused if the nodule affects the nerves to the voice box.
Since most patients with thyroid nodules do not have symptoms, most nodules are discovered during a routine physical exam or incidentally with imaging (CT scan, Ultrasound) for other concerns. Once the nodule has been discovered, you doctor will try to determine whether the lump is benign (non-cancerous) or represents a low grade thyroid malignancy. Specialized tests such as thyroid ultrasound and/or thyroid scan can help determine if a biopsy is needed. Most thyroid nodules do not require treatment and can safely be monitored by your doctor. If the enlarged thyroid gland is causing symptoms or thyroid cancer is detected, then surgical removal of part, or all, of the thyroid is usually recommended.
PARATHYROID
The parathyroid glands are four small glands in the neck that are part of the endocrine system. They produce parathyroid hormone (PTH), which maintains calcium and phosphorus levels in the blood. The primary disease associated with the parathyroid glands is an overproduction of PTH, known as Hyperparathyroidism. This is usually caused by benign enlargement (adenoma) of one or more of the parathyroid glands. Hyperparathyroidism causes bone calcium loss and higher than normal calcium in the blood and urine. Many people have no symptoms and the condition is discovered with a routine blood test. Others have symptoms such as bone pain, osteoporosis, decreased memory, depression, fatigue, abdominal pain or kidney stones. In general, the symptoms resolve with time after surgery. This condition can run in some families, though more commonly it occurs without any family history. For most patients, the treatment involves surgical removal of the overactive parathyroid gland or glands (if there is more than one overactive gland).
Surgery is performed through a small incision in the front of the neck and the enlarged gland is removed. In most cases patients go home the same day as surgery. Recovery from parathyroid surgery is usually quick with minimal pain requiring pain medication for only a day or two and most people return to work in a week or less. Occasionally, extra calcium might need to be taken after surgery to replenish bone calcium and prevent low blood calcium levels.
FAQs
Thyroid
What is a thyroid nodule?
The term thyroid nodule refers to any abnormal growth of thyroid cells in a lump within the thyroid and they are very common. Up to half of all people have at least one thyroid nodule, although most have no symptoms.
What causes a thyroid nodule?
We do not know what causes most noncancerous thyroid nodules to form. 9 out of 10 nodules are benign (noncancerous). If the nodule is filled with fluid, it is called a thyroid cyst. Some patients’ thyroid may have a bumpy appearance that may be due to inflammation in the thyroid (Hashimoto’s thyroiditis).
What are the symptoms of a thyroid nodule?
Most thyroid nodules do not cause any symptoms. Your doctor usually discovers them during a routine physical examination or incidentally with imaging (CT, MRI, US) for other conditions. Or you might notice a lump in your neck while looking in a mirror. If the nodule is made up of thyroid cells that produce more thyroid hormone than your body needs, a patient may complain of hyperthyroid symptoms (see hyperthyroidism sheet). A few patients with thyroid nodules may complain of pain in the neck, jaw or ear. If the nodule is large, it may cause difficulty swallowing, “tickle in the throat” or shortness of breath if it is pressing on the windpipe. Rarely, hoarseness can be caused if the nodule affects the nerves to the voice box.
How is a thyroid nodule diagnosed?
Since most patients with thyroid nodules do not have symptoms, most nodules are discovered during a routine physical exam. Once the nodule has been discovered, you doctor will try to determine whether the lump is the only problem or if you have an issue with hormone production of your thyroid gland which is known as hypothyroidism or hyperthyroidism. The initial tests may include a blood draw to test thyroid hormones. Specialized tests such as thyroid ultrasound and/or thyroid scan can help determine if a biopsy is needed.
How are thyroid nodules treated?
Most thyroid nodules do not require treatment & can safely be monitored by your doctor. Sometimes surgical removal of part, or all, of the thyroid is recommended.
What are the symptoms of thyroid cancer?
In the early stages, most thyroid cancers have little or no associated symptoms. Many are found incidentally during imaging for other conditions. Further growth may produce a lump or nodule in the lower neck associated with the thyroid gland. Patients can sometimes experience rapid growth, pain, and swelling, difficulties with swallowing or hoarseness of voice. Thyroid cancer sometimes presents as enlarged lymph nodes in the neck.
Who is at risk for developing thyroid cancer?
There are 4 main types of thyroid cancer, with papillary and follicular thyroid cancer being the most common. People under the age of 50 are more likely to develop papillary thyroid cancer, with those aged 30 to 50 at the highest risk. However, adults over the age of 50 tend to have more aggressive disease. Additional risk factors include; a family history of thyroid cancer, a personal or family history of goiters, external beam radiation for cancer treatment, exposure to high levels of radiation caused by nuclear accidents or weapons testing, and a family history of certain genetic syndromes such as Cowden Syndrome. Papillary thyroid cancer is also more common in women than in men. So being a woman is considered a risk factor.
If I notice any of the symptoms, what should I do?
Begin by contacting Puget Sound ENT and scheduling your first appointment. Our in-house ENT specialists evaluate each patient and perform in-depth testing including in-office ultrasound and fine needle aspiration and biopsy of suspicious thyroid lesions for rapid diagnosis. Once a diagnosis is determined treatment options are discussed and coordinated with our multi-disciplinary team including endocrinology and oncology.
Parathyroid
What is hyperparathyroidism?
Hyperparathyroidism is overactivity of one or more of the parathyroid glands. This overactivity causes bone calcium loss and higher than normal calcium in the blood and urine.
What are the symptoms of hyperparathyroidism?
Many people have no symptoms and the condition is discovered with a routine blood test. Other patients have symptoms such as bone pain, osteoporosis, decreased memory, depression, fatigue, abdominal pain or kidney stones. In general, the symptoms resolve with time after surgery.
What is the treatment for hyperparathyroidism?
For most patients, the treatment involves surgical removal of the overactive parathyroid gland or glands (if there is more than one overactive gland).
What is the usual recovery from surgery?
In most cases, patients go home the same day as surgery. Recovery from parathyroid surgery is usually quick with minimal pain requiring pain medication for only a day or two and most people return to work in a week or less. Occasionally, extra calcium might need to be taken after surgery to replenish bone calcium and prevent low blood calcium levels.
Is hyperparathyroidism ever due to cancer?
Rarely is this condition due to a parathyroid gland cancer. In the vast majority of patients, there is no malignancy. In addition, the gland is always sent for testing to rule out cancer after the surgery.
Can hyperparathyroidism recur?
It’s possible but rare. In less than 5% of patients, the condition will either not respond to surgery or recur later. The majority of patients are cured permanently by surgery.