If there is under or over-production of thyroid hormone then treatment is with thyroid hormone replacement or antithyroid medication under the supervision of an endocrinologist. Radioactive iodine treatment, radiofrequency ablation of nodules or surgical removal are other alternatives.
For benign nodules, management will be dependent on whether they are causing compression of the breathing or swallowing apparatus or indeed if there is a large component of the gland that is behind the breastbone. In these situations, removing either half of or the whole thyroid gland may relieve symptoms.
If there is a concern about the size of a benign thyroid nodule (or multiple nodules) treatment options will include surgery and also a new less-invasive technique of radio-frequency ablation. OneWelbeck is one of the very few private centres in the UK offering this technique, and radio-frequency ablation is provided by one of our expert radiologists in OneWelbeck ENT
Before a patient can be booked for radio-frequency ablation, we require that each patient has an assessment booked with our Specialist Radiologist where two ultrasound-guided fine needle aspiration procedures are performed with a two-week interval. Once these are completed and radio-frequency ablation is deemed appropriate as per the result on the biopsy, then the procedure can be carried out in OneWelbeck ENT. To book, please call 020 3653 2007.
About 5% of solitary thyroid nodules turn out to be cancerous. The commonest type is called papillary thyroid cancer. This has the best prognosis and comprises 80% of all thyroid cancers.
Modern management of thyroid cancer favours thyroid gland preservation in certain situations. Multiple studies have demonstrated that many small cancers with favourable histological features, in a low risk patient are not likely to grow much throughout their lifetime. For larger tumours or if there is more than one suspicious area in the thyroid and for the more aggressive cancer types, surgery is likely to be recommended.
All diagnosed or possible thyroid cancers will be discussed in a thyroid cancer multidisciplinary meeting to ensure the best individualised and evidence-based treatment is offered. Depending on the properties of the cancer, following the removal of your thyroid gland, you may need radioactive iodine treatment which will be administered by an endocrinologist.
We are a team of ENT Head and Neck surgeons with significant experience in managing complex thyroid cancers and very large retrosternal goitres. Where necessary, because we regularly perform other types of head and neck cancer surgery, we are also skilled in performing neck lymph node clearances with preservation of important nerves and major vessels.
We routinely use nerve monitoring to help us identify and preserve the nerves to the voice box, as these are intimately related to the under-surface of the thyroid gland (the recurrent laryngeal nerve and external branch of the superior laryngeal nerve). In addition, it is also critically important to preserve the closely associated small glands (parathyroid glands) that regulate calcium levels in the body.