Discharge Instructions: Thyroidectomy
Important information:
Thyroidectomy is the surgical removal of all or part of the thyroid gland in the neck. The thyroid gland produces hormones that regulate digestion. Children with hyperthyroidism, thyroid nodules, or thyroid cancer may need this surgery. Depending on your child’s condition, your surgical team may recommend:
About the operation
The operation is done under general anesthesia, so your child will not remember or experience pain during the procedure because they are asleep. An incision is made in the front of the neck. All or part of the thyroid gland will be removed. The incision is then closed, and the edges stitched together. A drain may be left in place overnight.
In cases where thyroid cancer is suspected, lymph nodes in the center of the neck may be removed. A biopsy will be performed to check for cancer. If lymph nodes look suspicious of cancer or cancer has been confirmed by biopsy, the nodes will be removed
The procedure may take 2-4 hours. If the lymph nodes need to be removed, the procedure time may be extended. The hospital stay after removal of the entire thyroid gland is 2-3 nights. Depending on your child’s recovery, they may stay for a longer period. After a thyroid lobectomy, most patients can go home the same day as the surgery. 
After the operation
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Your child’s neck will be sore after surgery. This may last for several days. The healthcare team will give your child pain medicine to keep them comfortable
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Some children may have a hoarse voice for 2-3 days.
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Depending on how much of the thyroid gland was removed, your child may begin taking thyroid replacement hormones. The endocrinology team will order thyroid medicine, if needed.
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In cases of total thyroidectomy or completion thyroidectomy where the remaining thyroid tissue is removed in cases of thyroid cancer, supplemental calcium will be started immediately after surgery. The endocrinology team will order the calcium supplements.
Pain
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Your child may still complain of neck pain. The healthcare team will prescribe pain medicine for your child. The medicine may be a narcotic. You may use ibuprofen (Motrin®) every 6-8 hours as needed. Follow the dosage instructions on the medicine label.
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Narcotics may cause constipation. Increase fiber (fruits, bran, and vegetables) and drink extra fluids. If needed, over the counter laxatives may be used
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Avoid keeping the neck still; this will cause stiffness and pain. For neck stiffness, you may:
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Use a heating pad
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Massage neck and shoulder muscles
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Use ice packs (20 minutes on and 20 minutes off)
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Flex and stretch neck muscles
Incision care
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Your child may bathe or shower. The healthcare team will let you know when they can get the neck wet. There will be paper strips covering the incision. A clear glue called Dermabond™ may be placed over the strips. The strips will gradually fall off
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Swelling or bruising may be seen around the incision line. This is seen on day 2 or 3 after the procedure. Your child may also have numbness of the skin around the incision line. This will slowly improve during recovery but may last for a few months.
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The scar will be visible 1-2 months after the operation and gradually fade over the next 6-8 months. As it heals, the skin around the scar may look pink or red. The healthcare team will give you information on how to care for the incision.
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Your child may feel a firm healing ridge just below the incision line. This is normal and will soften and go away when healing is complete.
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All incisions are sensitive to sunlight. For one year after surgery, your child should use sun protection factor (SPF) 50 or greater when outdoors. This will prevent darkening of the scar. You may also choose to cover the incision with a scarf or bandage in addition to the sunblock. Do not expose the incision to ultraviolet lights used in tanning booths.
Activity
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Your child may return to school and activities when they feel ready. Avoid strenuous activity, lifting heavy objects and contact sports for two weeks after surgery.
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Your surgeon will tell you if there are limits on activity.
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Call to schedule a follow-up appointment in 4 weeks.
Contact your CHOP ENT team with questions, concerns or if your child has:
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A temperature greater than 101.3°F (38.5° C) under the arm or greater than 102.2°F (39° C) by mouth
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Bleeding or drainage from the incision site
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Increased pain or swelling, foul smell or odor around the incision site
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Vomiting or is unable to keep down fluids
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A tingling sensation around the mouth or fingertips, muscle aches, weakness or twitching
215-590-3440
7 days per week/24 hours
Reviewed February 2024 by Tyree D. Smith, MSN, CRNP, CPNP-AC, CORLN, CPEN.