What are the risks of my surgery?

1. Neck Hematoma:

  • Any surgery caries a risk of bleeding.
  • If this happens after your thyroid has been removed, the cavity in your neck can fill with blood and produce neck swelling.
  • A neck hematoma only happens in about 1% of cases and usually within the first 24 hours.
  • If you do notice increasing neck swelling following your surgery, especially if it is rapid swelling, you should let your nurse know right away or if you are at home, call 911 or go to the closest emergency department immediately. 
  • A neck hematoma can be very serious and can affect your breathing.
  • Other symptoms include increased bleeding around your incision, difficulty swallowing and increased pressure in your neck.
  • You may need to be taken back to the operating room to drain the blood out of your neck.

2. Temporary or permanent low calcium (hypocalcemia)

  • This can happen with total thyroidectomy (whole thyroid removed) or partial thyroidectomy (part of thyroid removed).
  • The parathyroid glands are 4 small glands that lie just behind the thyroid gland. Their function is to secrete a hormone that regulates your blood calcium.
  • If the parathyroid glands are affected during surgery, your calcium levels may drop and you may need to take calcium +/- Vitamin D pills. This is usually temporary until the glands recover (about a 30% risk) but can occasionally be permanent (about a 4% risk).
  • If your calcium drops very low, intravenous calcium may be required.
  • This can sometimes delay your discharge from hospital while your surgical team stabilizes your calcium.
  • If you experience symptoms of tingling or numbness in your hands, feet or face, this could be a sign of low blood calcium. If this occurs, it is important that you notify your health care team immediately or go the emergency department if you are already at home.

3. Injury to the laryngeal nerves

  • The recurrent laryngeal nerves (RLNs) innervate the muscles of your voice box (larynx), including your vocal cords.
  • During the surgery, the surgeon is very careful to preserve these nerves but if they are affected, your voice could become weak and breathy. This can either be temporary or permanent.
  • Injury to both RLNs is a very rare complication.
  • A branch of the superior laryngeal nerve controls small muscles in your voice box that are responsible for pitch control. If they are affected, you may notice difficulty controlling the pitch of your voice, especially at higher pitches.
  •  It is normal to feel vocal fatigue and difficulty raising your voice for a few months after surgery. If you don't see any improvement after this time you should talk to your surgeon.

4. Infection:

  • Any surgery caries a risk of infection. For thyroid surgery, it is estimated at 1-2%.
  • Your surgeon will be very careful to take all the necessary measures to reduce the risk of infection during surgery.

Signs of infection include:

  • Fever
  • Increasing redness or swelling around the incision site
  • Purulent drainage (yellow or greenish fluid) from the incision site

How can I minimize the risk of complications?

  • Restrain from any intense physical activity, heavy lifting or straining for 2 weeks after the surgery. This could cause increase pressure in the small vessels that were sealed during surgery and cause a neck hematoma.
  • Stay active: even if you can't do intense activity or heavy lifting, you should be walking early after the surgery and avoid staying in bed all day to optimize your heart and lung function.
  • Take your calcium supplements and thyroid hormones as prescribed by your physician.