Mr Ram Moorthy
Otolaryngology / ENT

What are the reasons people undergo thyroid surgery?

Published: 01/04/2019 | Updated: 27/07/2023

Edited by: Laura Burgess

There are four main reasons that patients may require thyroid surgery, which can either be the removal of all of the thyroid gland, a (total) thyroidectomy or a (partial) hemithyroidectomy. We invited leading consultant otolaryngologist and ENT head and neck surgeon Mr Ram Moorthy explains more and whether the procedures leave a scar.

What are the four reasons to undergo thyroid surgery?

Thyroid nodules

Thyroid nodules are common, affecting up to ten per cent of females and two per cent of males. The vast majority (95 per cent) are benign but should be evaluated by a thyroid surgeon. The surgeon will discuss further investigations, which will include blood tests, an ultrasound scan of the neck and possibly a needle biopsy of the nodule (fine needle aspiration cytology), which is usually undertaken at the same time as the ultrasound.

If following evaluation a nodule is considered atypical or suspicious for cancer it will be discussed in a multi-disciplinary team (MDT) meeting involving surgeons, pathologists and radiologists and they may recommend surgery to remove part or all of the thyroid gland.

Overactive thyroid

Patients with an overactive thyroid gland (thyrotoxicosis) may be recommended surgery by their endocrinologist as definitive treatment. Thyrotoxicosis can be due to an overactive nodule in which case removal of half the thyroid gland including the nodule (hemithyroidectomy) may be sufficient to cure the problem. If the whole gland is involved then a total thyroidectomy is required where all of the thyroid gland is removed.

Enlarged gland

The thyroid gland can become enlarged, which can be due to nodules (multi-nodular goitre or MNG) or the whole gland enlarged (diffuse goitre). This is typically a gradual process and can cause problems with swallowing, tightness in the neck, sleeping and breathing (called compressive symptoms). These symptoms can have a significant impact on quality of life. Surgery to remove all or part of the gland can be undertaken to provide symptomatic relief.

Cosmetic concerns

The final reason a thyroid may be removed is for aesthetic reasons if the nodule is unsightly.

Will thyroid surgery leave me with a scar?

Traditionally thyroid surgery is undertaken via an incision on the front of the neck. This typically heals with little scarring apart from a thin line on the front of the neck. Scarring is, unfortunately, a possible complication. In many cultures, patients want to avoid a scar on the neck and a variety of techniques have been developed which include:

• Minimally invasive surgery - via a shorter incision (2cm vs. 4cm) on the front of the neck
• Axillary (armpit) approach - which can be undertaken using a surgical robot
• Transoral approach - this leaves no visible scar on the body but it is currently not available in the UK

If you are worried about your thyroid and wish to schedule a consultation with Mr Moorthy, you can do so by visiting his Top Doctors profile.

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By Mr Ram Moorthy

Otolaryngology / ENT in London

Mr Ram Moorthy is a highly qualified consultant otolaryngologist and ENT head and neck surgeon with private clinics at The London ENT and Balance Centre, The Bridge Clinic in Maidenhead, Spire Thames Valley Hospital, Wexham and The Princess Margaret Hospital in Windsor. He offers a full general adult and paediatric ENT service with specialist training in head and neck surgery, including thyroid and parathyroid surgery. He is the only surgeon to locally offer a coblator intracapsular tonsillectom...

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We will call you back

By Mr Ram Moorthy
Otolaryngology / ENT

Mr Ram Moorthy is a highly qualified consultant otolaryngologist and ENT head and neck surgeon with private clinics at The London ENT and Balance Centre, The Bridge Clinic in Maidenhead, Spire Thames Valley Hospital, Wexham and The Princess Margaret Hospital in Windsor. He offers a full general adult and paediatric ENT service with specialist training in head and neck surgery, including thyroid and parathyroid surgery. He is the only surgeon to locally offer a coblator intracapsular tonsillectomy and transnasal oesophagoscopy.

After earning his BSc in clinical anatomy from Guy’s and St Thomas Hospitals, he trained in ENT, oral and maxillofacial surgery and neurosurgery before enhancing his ENT skills at Charing Cross Hospital. Mr Moorthy spent time as a senior trainee at Great Ormond Street Hospital for Sick Children and completed a national interface fellowship in head and neck surgical oncology at The Queen Elizabeth Hospital in Birmingham. Outside his private clinics, Mr Moorthy is a consultant ENT surgeon at Wexham Park Hospital, part of Frimley Health NHS Foundation Trust and an honorary consultant head and neck surgeon at The Royal Berkshire Hospital, trains ENT surgeons at Wexham Park and is the ENT training programme director for Thames Valley.
He is an Executive Committee member of the British Association of Endocrine and Thyroid Surgeons.
In the past, he was an honorary clinical lecturer at the University of Birmingham and an MSc supervisor at the University of Edinburgh. Mr Moorthy has held a number of esteemed positions at the British Medical Association, including Chairman of the UK Junior Doctors Committee and Deputy Chairman of the Board of Science. He is a fellow of the Royal College of Surgeons, a member of ENT-UK, and Royal Society of Medicine. He has a produced a number of ENT textbook chapters, for prestigious textbooks such as Stell and Maran’s head and neck surgery and oncology.

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