Thyroid gland, parathyroid glands, adrenal gland
The thyroid gland is the pacemaker of our entire organism.
Thyroid glands, parathyroid glands and the adrenal glands belong to the field of endocrine surgery. This is the surgery of the hormone-producing organs that fulfill important functions of our metabolism.
The thyroid gland produces the thyroid hormones thyroxine, or T4 for short, and triiodothyronine, or T3 for short. These act on many different organs in the human body and function as a kind of accelerator pedal for the metabolism. The thyroid gland needs sufficient iodine to produce thyroid hormones.
The parathyroid glands regulate calcium metabolism, the adrenal glands produce stress hormones and sex hormones.
With Dr. med. Anita Scheiwiller, we have a very experienced expert in thyroid and parathyroid surgery in our team.
Which thyroid diseases are common?
Goiter
This is the most common disease of the thyroid gland. It is a benign nodular enlargement of the thyroid gland and the main cause is an iodine deficiency. As many foods today are enriched with iodine (e.g. our table salt), goiters are no longer as common as they used to be.
Thyroid cancer
Dies ist eine bösartige Vergrösserung der Schilddrüse und ist sehr viel seltener als gutartige Vergrösserungen. Die Prognose ist sehr viel besser als bei vielen anderen Krebserkrankungen.
Malfunctions
Hypothyroidism: too few thyroid hormones are produced. This results in tiredness, weight gain, feeling cold or a low pulse. Dry skin and brittle hair are also typical signs of hypofunction.
Hyperthyroidism: too many hormones are released. This leads to the opposite symptoms, i.e. sweating, weight loss, nervousness or palpitations. Hyperthyroidism can also lead to an enlargement of the thyroid gland.
Inflammation, autoimmune diseases or an iodine deficiency may be the cause of a functional disorder.
What are the symptoms of thyroid disease?
If the thyroid is underactive, our metabolism slows down, while if it is overactive, it speeds up. The symptoms of dysfunction are correspondingly diverse. They range from weight changes and tiredness to nervousness and heart palpitations. An enlarged thyroid can press on the windpipe or esophagus, causing difficulty swallowing or shortness of breath.
What diagnostic options are there?
Zu einer Untersuchung der Schilddrüse gehört immer eine Laborkontrolle der Schilddrüsenhormone. Zudem wird ein Ultraschall durchgeführt, um eine Vergrösserung des Organs zu sehen. Bei Knoten kann eine Biopsie mittels Feinnadelpunktion durchgeführt werden. Eine Szintigrafie misst die Stoffwechselfunktion der Schilddrüse.
When must an operation be performed?
Functional disorders of the thyroid gland can often be treated with medication. However, if the therapy does not respond sufficiently or is poorly tolerated, an operation is advisable, especially in the case of hyperthyroidism.
Surgery should also be performed in the case of goitre if symptoms occur or if the nodules change rapidly. In the case of thyroid cancer or even if a malignant change is strongly suspected, surgery should always be performed immediately.
What does thyroid surgery look like?
The operation begins with a transverse incision in the lower neck area. The thyroid gland is then reached between the short neck muscles. The organ is shaped like a butterfly. We always operate with magnifying glasses so that the very fine structures are clearly visible. Injury to the vocal cord nerve located directly below the thyroid gland must be avoided at all costs. We use neuromonitoring to make the nerve signal audible. The four very small parathyroid glands adjacent to the thyroid gland should also always be spared.
If only one side of the thyroid gland is enlarged or diseased, unilateral surgery is sufficient. The entire thyroid tissue on one side is removed. If both sides are affected, the entire organ must be removed. If surgery is performed on one side, normal hormone function usually continues. In the case of bilateral surgery, the thyroid hormones must be taken in tablet form afterwards. However, this is very simple. The hormones must then be checked every 6-12 months.
A thyroid operation takes 1.5-2 hours, followed by a hospital stay of 2 days.