Tonsils are small glands in the throat, initially vital for fighting germs in young children.

They become less significant after age five, and removal is considered if causing frequent sore throats or obstructing breathing.

Why removal?

Removal is recommended for recurrent sore throats affecting school attendance or when enlarged tonsils obstruct breathing, especially during sleep.

Pre Surgery

• Arrange a couple of weeks off school for the child.
• Report any recent sore throat or cold before the operation.
• Disclose any family history of bleeding or bruising problems.

Operation Procedure:

• Done under general anesthesia, taking approximately 30 minutes.
• The surgery is a brief procedure  done through the mouth, does not require any cuts or sutures, and recovery varies, most children leaving hospital on the same day.
• Techniques for removal include traditional methods and modern approaches like electric diathermy and Coblation wands.
• Post-operation, the child is monitored in a recovery area for about an hour.

Hospital Stay:

• Tonsil surgery may be performed as a day case or may involve an overnight stay, depending on the hospital and the time of the operation.
• Discharge occurs when the child is eating, drinking, and feeling well enough.

Possible Complications:

• Bleeding is the most serious complication, occurring in about 2% of cases.
• Some children may feel nauseous after the operation, usually resolving quickly.
• Sore throat, pain, and white appearance are common post-operation, gradually improving.
• Regular painkillers, avoiding aspirin.
• Encourage cold  & soft  food intake to aid healing, Ice creams and shakes.
• Sore ears are normal and usually not indicative of an infection.
• Throat may appear white, and small threads may be visible, falling out on their own.
• Watch for signs of throat infection, fever, and bad smell, seeking medical advice if necessary.

Post-Operation Care:

• Keeping the child at home, away from crowds and ensuring rest, is recommended for 10 to 14 days post-surgery.
• In case of any bleeding from the throat requires immediate medical attention, either from the GP, ward, or hospital casualty department.

Tonsils are small glands in the throat, initially vital for fighting germs in young children.

They become less significant as you get older, and removal is considered if causing recurrent sore throats, airway blockage, or in the presence of an abscess or suspected tumor.

Why Surgery?

• Recurrent sore throats despite antibiotic treatment compromising quality of life.
• Airway blockage due to large tonsils.
• Prevention of quinsy (tonsil abscess) recurrence.
• Suspected tonsil tumor (rare).

Pre-Surgery Considerations:

• Arrange for two weeks off work.
• Inform about chest infection or tonsillitis before admission.
• Disclose any unusual bleeding or bruising problems or family history of such issues.

Operation Procedure:

• Done under general anesthesia, taking approximately 30 minutes.
• Tonsils are removed through the mouth, no cuts or sutures are required and bleeding is controlled.
• Techniques for removal include traditional methods and modern approaches like electric diathermy, Harmonic scalpel and Coblation wands.

Hospital Stay:

• Typically, surgeons prefer a one-night stay after tonsillectomy.
• In some cases, it may be done as a day case, depending on hospital protocols and proximity to home.

Possible Complications:

• Bleeding is the most serious complication, occurring in about 5% of cases.
• Tooth damage is a very small risk during the operation.
• Changes in taste perception may occur post-operation.

Post-Operation Care:

• Throat will be sore for around ten days; regular painkillers are essential.
• Avoid aspirin to prevent bleeding.
• Eating soft and cold food like ice cream which aids healing; stay hydrated with bland, non-spicy food.
• Sore ears are normal and not indicative of an ear infection.
• Throat may appear white; small threads may fall out on their own.
• Watch for signs of throat infection; seek medical advice if necessary.
• 10 to 14 days off work are recommended for rest and recovery.
• Any bleeding from the throat requires immediate medical attention.

Red Flag:

• In case of bleeding, see a doctor promptly; contact GP, ward, or nearest hospital casualty department.

Some children get fluid behind the eardrum. This is called 'serous otitis media' or 'glue ear.' It is very common in young children, but it can happen in adults too.

What are Grommets?

Small plastic tubes placed in a hole in the eardrum to allow air in and out, maintaining ear health.

Why Use Grommets?

Address fluid behind the eardrum, often termed 'glue ear,' which can affect hearing or cause repeated ear infections.

Surgery: Myringinotomy for placement of gromets:

• Done under short general anesthesia as a day case admission.
• Microscopic procedure through the ear canal with a small opening in the eardrum.
• Fluid suctioned out, and grommet placed in the eardrum opening.
• Procedure duration: 10-20 minutes.

Duration of Grommets:

• Grommets fall out naturally as the eardrum grows, staying in for around six months to a year or longer in older children.
• Duration varies, and the falling out may go unnoticed.
• Alternatives discussed, including steroid nasal sprays, adenoid removal, or hearing aids.

Post-Operation Care:

• Encourage clear communication with the child.Grommets typically not sore; painkillers can be given if needed.
• Immediate hearing improvement, but some adjustment may be required.
• Fewer ear infections; mild infections treated with antibiotic ear drops.

Swimming and Water Precautions:

• Swimming allowed after a couple of weeks; caution against diving underwater.
• Earplugs or cotton-wool covered in Vaseline advised for bathing or showering.

Return to Normal Activities:

• Child can usually return to nursery or school the day after the operation.

Flight and Hearing Checks:

• Flying in an airplane with grommets is safe; no pressure-related pain.
• Hearing checks after grommet placement and post-grommet removal check, typically nine to twelve months after the operation.

Potential Complications:

• Rarely, a small hole in the eardrum may remain after a grommet falls out, usually healing on its own.

What are the adenoids?

Adenoids are small glands located at the back of the nose. In younger children, they are there to fight germs. We believe that after the age of about two years, the adenoids are no longer needed.

Do we need our adenoids?

Your body can still fight germs without your adenoids. They probably only act to help fight infection during the first two years of life: after then, we only take them out if they are doing more harm than good.

Why do adenoids cause problems?

Sometimes children have adenoids so big that they have a blocked nose, so that they have to breathe through their mouths. They snore at night.Some children even stop breathing for a few seconds while they are asleep(Sleep Apnoea). The adenoids can also cause ear problems by preventing the tube which joins your nose to your ear, from working properly.

Some benefits of removing adenoids

• For children with glue ear.
• Reduces colds.
• Removing the adenoid may reduce the problem of a blocked nose when your child has a cold.

Is there an age limit for adenoidectomy?

Adenoidectomy is generally avoided in children under 15 kg of weight, approximately under 2 years of age, because of the small risk of blood loss during or after the operation. There is no upper age limit, but the adenoid has usually shrunk to almost nothing by the teens.

How are the adenoids removed?

The traditional technique is to use a curette, which is a special type of surgical cutting device. This is a safe technique, although a consideration for small children having the operation is that the blood loss may be higher at the time of surgery.

Other techniques are becoming more popular:

Electric diathermy and Coblation dissection have the advantage of less blood loss at the time of surgery.

The laser has fallen out of Favor because of the much higher levels of pain after the operation.

Is it true that the adenoid may grow back?

This is possible but uncommon.

Who is suitable for day case surgery, and who would require inpatient stay?

Generally, children who are fit and well with no bleeding or bruising disorders are fit for day surgery.

What is the recovery time after surgery?

It is wise to allow a one-week convalescence period.

Is there any long-term risk to having your adenoids removed (e.g., reduced immune function)?

There is NO good evidence that adenoidectomy reduces immune function or makes people more prone to chest infections.

What makes you decide to remove the tonsils at the same time?

If your child gets lots of tonsillitis (sore throats) or has difficulty breathing at night, then we may decide to take out the tonsils at the same time as the adenoids.Its a twin surgery works well.

Preparing for your child's operation or things to do before your child's operation

Arrange for a week at home or off school after the operation.

Things we need to know before the operation

Let us know if your child has a sore throat or cold in the week before the operation - it will be safer to put it off for a few weeks.

It is very important to tell us if your child has any unusual bleeding or bruising problems, or if this type of problem might run in your family.

How is the Surgery done?

Your child will be asleep.

We will take his or her adenoids out through the mouth, and then stop the bleeding. This takes about 10 minutes.

Your child will then go to a recovery area to be watched carefully as he or she wakes up from the anesthetic.

He or she will be away from the ward for about an hour in total.

How long will my child be in hospital?

The adenoid surgery is done as a day case so that he or she can go home on the same day as the operation. Very rarely may prefer to keep children in the hospital for one night,especially the children with a sleep disorder for observation. Either way, we will only let him or her go home when he or she is eating and drinking and feels well enough.

Most children need no more than a week off nursery or school. They should rest at home away from crowds and smoky places. Stay away from people with coughs and colds.

Can there be problems?

Adenoid surgery is very safe, but every operation has small risks.

The most serious problem is bleeding, which may need a second operation to stop it. However, bleeding after adenoidectomy is very uncommon. It is very important to let us know well before the operation if anyone in the family has a bleeding problem.

After the operation

• Some children feel sick after the operation. This settles quickly.
• A small number of children find that their voice sounds different after the surgery. It may sound like they are talking through their nose a little. This usually settles by itself within a few weeks. If not, speech therapy is helpful.
• Your child's nose may seem blocked up after the surgery, but it will clear by itself in a week or so.
• Your child's throat may be a little sore
• Give painkillers as needed for the first few days.
• Do not use more than it says on the label.
• Do not give your child aspirin- it could make your child bleed. (Aspirin is not safe to give to children under the age of 16 years at any time, unless prescribed by a doctor).
• Prepare normal food. Eating food will help your child's throat to heal.
• Chewing gum may also help the pain.
• Your child may have sore ears
• This is normal. It happens because your throat and ears have the same nerves. It does not usually mean that your child has an ear infection.
• Your child may also feel tired for the first few days

Red Flag:

In case of bleeding, see a doctor promptly; contact GP, ward, or nearest hospital casualty department.

What is septal surgery?

Septal surgery involves the correction of a bent nasal septum, which is a thin piece of cartilage and bone inside the nose between the right and left sides. It is about 7 cm long in adults. In some people, this septum is bent into one or both sides of the nose, causing a blockage. The surgery aims to straighten the septum and relieve blockage.

Why have septal surgery?

If you have a blocked nose due to the bend in the septum, the operation can help.

Sometimes, straightening out a bent septum is necessary to create space for other procedures, such as sinus surgery. The operation is not intended to change the appearance of your nose.

How is the operation done?

The operation typically takes about 30-45 minutes. You might be asleep, although in some cases, it can be performed with only your nose anesthetized. The procedure is usually performed inside your nose,using a telescope and camera leaving no scars or bruises on your face. A cut is made inside your nose to straighten the septum by removing some cartilage and bone and repositioning the rest of the septum back to the middle of the nose. Stitches are used to hold everything in place. Complex cases may require a cut across the skin between the noses and may be combined with rhinoplasty procedures.

Nasal Packs and splints

Packs may be inserted into each side of your nose to prevent bleeding and maintain position. These packs, also known as dressings, will block your nose, requiring mouth breathing. They are removed the morning after the operation, and any bleeding upon removal usually settles quickly.

Small plastic pieces called splints may be placed in your nose to prevent scar tissue formation. These are typically removed after about a week.

Does it hurt?

Not significantly, but the front of your nose may be tender for a few weeks.

After the Surgery

• You may be given drops or a spray to aid in recovery. It may take up to three months for your nose to settle down, and your breathing to become clear again. Avoid dusty or smoky places during this time.
• Stitches inside your nose will dissolve and usually fall out by themselves.
• Do not blow your nose for about a week to prevent bleeding.
• If you need to sneeze, do so with your mouth open to protect your nose.
• Some blood-colored watery fluid from your nose in the first two weeks is normal.
• Your nose will be blocked on both sides, similar to a heavy cold, for 10-14 days after the operation.

How long will I be off work?

You can expect to go home the day after your operation, and sometimes on the same day. Rest at home for at least a week. If your job involves heavy lifting, consider taking two weeks off. Avoid sports with a risk of nose injury for about a month. Check with your nurse if you need a sick note for your time in the hospital.

Possible complications

• Septal surgery is generally safe, but there are some risks.
• Nosebleeds may occur after the operation, and packs may be required to stop them. Bleeding can happen within the first 6-8 hours or up to 5-10 days after surgery. In rare cases, a return to the operating theatre with another general anesthetic may be necessary to address severe bleeding.
• Infection is rare but serious if it occurs. See a doctor if your nose becomes increasingly blocked and sore. A hole in the septum, causing whistling noises, crusting, or nosebleeds, is a rare complication. While often asymptomatic, surgery may be required to repair the hole.
• Very rarely, a slight change in the shape of the nose may occur, with a dip in the bridge. Most people don't notice any change, but corrective surgery is an option if desired.
• Occasionally, there may be some numbness of the teeth and rarely altered smell which usually resolves with time.

Sinuses, air-filled spaces in the face and head, play a crucial role in nasal breathing and mucus flow. Sinusitis, caused by inflamed or infected sinuses, leads to symptoms like congestion, headaches, and reduced sense of smell. While most cases respond to non-surgical treatments, severe or persistent sinus issues may necessitate Functional Endoscopic Sinus Surgery (FESS)

FESS is a surgical approach for challenging sinus problems.

It is considered when non-surgical treatments, such as  nasal sprays and oral medications, fail to provide relief.

How the surgery is done?

FESS is typically performed under general anaesthesia, but local anaesthesia is an option.

Using endoscopes and cameras ,microdebriders and  specialized instruments, surgeons unblock sinuses by removing excess tissue or bone.

Post-Operative Care:

Initial congestion and discomfort are common but temporary.

Patients should avoid blowing their nose for the first 48 hours.

Some mucus and blood drainage are normal during the recovery period.

Saline Nasal wash is a must with provided solutions.

Recovery and Return to Work:

Rest at home for at least a week, with heavier physical activity requiring a longer absence.

Specific instructions for post-operative care will be provided.

Possible Complications:

Complications are rare but may include bleeding, eye problems, and spinal fluid leaks.

Serious complications are extremely uncommon, with eye  complications  rarely occurring in one in every five hundred operations, However with advent of Neuronavigation Technology(similar to GPS Guided systems) complications are rare.

In summary, Functional Endoscopic Sinus Surgery is a safe and effective option for severe sinus conditions when conservative treatments prove insufficient. Patients considering FESS should engage in open discussions with their healthcare providers to make informed decisions about their treatment plan.

Turbinoplasty is a surgical procedure designed to address issues related to the nasal turbinates, which are structures inside the nasal passages that help regulate airflow and filter air. Radiofrequency surgery is a technique employed in turbinoplasty to reduce the size of the turbinates, alleviating symptoms such as nasal congestion and difficulty breathing.

Indications:

• Turbinate hypertrophy: Enlargement of the turbinates, leading to nasal obstruction.
• Chronic nasal congestion: Persistent nasal blockage that doesn't respond well to conservative treatments.
• Nasal breathing difficulties: Difficulty in breathing through the nose due to hypertrophied turbinates.

How we do the Surgery:

• Anesthesia: The procedure is often performed under local anesthesia to numb the area, although general anesthesia may be an option in some cases.
• Radiofrequency Energy: During the surgery, a special device with an electrode is used to apply controlled radiofrequency energy to the turbinates. This energy heats the tissues and causes controlled coagulation, leading to a reduction in the size of the turbinates.
• Precision and Control: The radiofrequency energy is delivered with precision, allowing the surgeon to target specific areas of the turbinates. This helps in minimizing damage to surrounding tissues.
• Minimally Invasive: Turbinoplasty using radiofrequency surgery is considered a minimally invasive procedure. It is typically performed on an outpatient basis, and patients can often return home on the same day.

Benefits:

• Reduced Nasal Congestion: By reducing the size of the turbinates, airflow through the nasal passages is improved, alleviating nasal congestion.
• Improved Nasal Breathing: Patients often experience improved nasal breathing and a reduction in symptoms such as snoring.
• Quick Recovery: The recovery time is generally shorter compared to traditional surgical techniques.

Postoperative Care:

• Patients may experience some mild discomfort, swelling, or nasal drainage in the days following the procedure.
• Nasal saline irrigation may be recommended to keep the nasal passages moist and promote healing.
• Avoiding activities that may increase nasal pressure, such as heavy lifting or vigorous exercise, is usually advised during the initial recovery period.

Risks and Considerations:

While turbinoplasty using radiofrequency surgery is generally safe, there are potential risks, including infection, bleeding, or changes in sensation.

As with any surgical procedure, individual responses to treatment may vary.

Uvulopalatopharyngioplasty (UPPP) is a surgical procedure designed to treat snoring and obstructive sleep apnea (OSA) by removing or modifying tissues in the upper airway that is mainly throat.

Indications:

• Obstructive Sleep Apnea (OSA): UPPP is often recommended for individuals with moderate to severe obstructive sleep apnea who haven't responded well to other treatments.
• Chronic Snoring: It may also be considered for individuals who snore loudly but do not have sleep apnea.

Procedure:

Anesthesia: UPPP is usually performed under general anesthesia, meaning the patient is completely asleep and feels no pain during the procedure.

Surgical Procedure

• Uvula: The uvula, the small, fleshy piece hanging down at the back of the throat, may be partially or completely removed by radiofrequency or blade.
• Soft Palate: A portion of the soft palate at the back of the mouth may be trimmed or repositioned to increase the size of the airway.
• Tonsillectomy: Both tonsils are removed and the  anterior and posterior pillars are sutured.
• Pharyngeal Wall Modification: The surgeon may perform additional procedures to modify the pharyngeal walls, such as removing excess tissue or tightening the muscles.
• Sutures and Healing: The surgeon uses dissolvable sutures to close the incisions. The goal is to create a wider airway passage to reduce snoring and alleviate obstruction during sleep.

Postoperative Care:

• Pain Management: Patients may experience some throat pain or discomfort after the surgery. Pain medication and throat lozenges may be prescribed to manage discomfort.
• Diet: A soft and cold diet may be recommended initially to avoid irritation to the surgical site.
• Follow-up Appointments: Follow-up appointments with the surgeon are typically scheduled to monitor healing and address any concerns.

Risks and Considerations:

• Pain and Discomfort: Throat pain and discomfort are common in the initial days following the surgery.
• Swelling: Swelling may occur, affecting swallowing and speech temporarily.
• Changes in Voice: Some individuals may experience changes in their voice, particularly if the uvula has been removed.
• Bleeding and Infection: As with any surgical procedure, there is a risk of bleeding or infection.
• Efficacy: While UPPP can be effective in reducing snoring and improving sleep apnea symptoms, its success can vary among individuals.

Alternative Sleep APNOEA  Treatments:

Continuous Positive Airway Pressure (CPAP): CPAP therapy involves wearing a mask over the nose or nose and mouth during sleep, delivering a continuous stream of air to keep the airway open.

Oral Appliances: These devices are designed to reposition the tongue or jaw to prevent airway obstruction during sleep.

The ear, comprising the outer, middle, and inner ear, plays a vital role in sound transmission. A hole in the eardrum, known as a perforation, can occur due to infection or injury, potentially leading to discharge or hearing loss. Tympanoplasty, a surgical procedure, aims to repair the eardrum, offering benefits such as preventing water entry and improving ear health.

SURGERY

The surgery is done, often under general anesthesia, involves creating a cut behind or above the ear. Other techniques including using a microscope trans-canal tympanoplasty or Using a telescope-Endoscopic tympanoplasty.

A small graft from beneath the skin  is placed against the eardrum to close the perforation.

Dressings may be used, and external dressings or head bandages could be applied.

Myringoplasty is successful in closing small perforations in about 90% and above in most of cases.

Success rates may vary for larger perforations.

Possible Complications:

Taste disturbance: Rare, temporary or permanent alteration in taste.

Dizziness: Common temporarily, rarely prolonged.

Hearing loss: Severe deafness in a small number of cases.

Tinnitus: Ear noise perception may occur.

Facial paralysis: A slight chance of facial muscle paralysis.

Post-Operative Care:

Pain can be managed with prescribed painkillers.

Discharge from the ear may occur, and dressings will be removed by the surgeon.

Keep the ear dry, avoid vigorous nose blowing, and use cotton wool coated with Vaseline during showers.

Recovery and Return to Work:

The recovery period varies, with an estimated two to three weeks off work.

The ear comprises the outer, middle, and inner ear, working together to transmit sound signals to the brain. Human ear is prone to infections and sometimes the ear infections extend into the bone behind the ear. The mastoid bone, located behind the ear, is connected to the middle ear and can be affected by ear infections.

Mastoid surgery becomes necessary when deep seated infections, particularly cholesteatoma, extend into the mastoid, causing hearing loss and erosion of structures.

Mastoid surgery is performed under general anesthesia, taking one to three hours.

Surgeons may use various techniques like atticotomy or mastoidectomy, involving a  small cut above or behind the ear.

The infected mastoid cells are removed, creating a mastoid cavity, which may be left open or closed using tissue from around the ear.

Recovery:

• Pain is manageable with prescribed painkillers.
• Success rate is over 80%, often improving hearing.
• Possible complications include hearing loss, dizziness, tinnitus, and rare facial weakness.
• Typically discharged a day after surgery.
• Dizziness may occur but usually resolves quickly.
• Stitches(if any) removed 1-2 weeks post-op, and packing in the ear canal removed after 2-3 weeks.
• Follow-up appointments for up to 5 years may be required.

Aftercare:

• Keep the ear dry, use a cotton wool ball coated with Vaseline during showers.
• Consult with ENT or GP if increased pain or swelling occurs.

Return to Work:

Approximately 2 weeks off work.

Alternative Treatment:

Mastoid surgery is the primary method to completely remove the infection.

For those unfit for surgery, regular ear cleaning by a specialist and antibiotic eardrops may reduce discharge, but won't eliminate the infection.

Microlaryngoscopy is the examination of the larynx (voice box) with or without surgical intervention under general anesthesia. Conducted to identify and treat voice box issues, such as hoarseness.

Pre-Surgery Considerations:

• Inform the surgeon about any history of neck problems.
• Notify the surgeon of loose or capped teeth.

Surgery

• Involves a laryngoscope and microscope for examination, with potential surgery using fine instruments.
• Biopsy may be taken for laboratory examination, and a laser might be used.
• Typically a brief operation (under 30 minutes).

Post-Surgery:

• Throat discomfort is common but can be managed with painkillers.
• Neck stiffness may rarely occur but is usually temporary.
• Voice use returns to normal, though temporary worsening may happen if biopsies are taken.
• Eating and drinking are usually possible later the same day.

Complications:

• Microlaryngoscopy is generally very safe.
• Slightly sore throat is common; extremely rare risk of metal tubes chipping teeth.
• Surgeon uses a gum guard to prevent tooth damage.

Results and Recovery:

• Surgeon communicates findings and actions on the same day.
• Biopsy results may take a few days.
• Usually, patients can go home on the same day, potentially staying overnight for observation.
• Return to work timing depends on the job, with a few days off recommended for throat rest.

Alternative Treatment:

Microlaryngoscopy is considered the primary method for a detailed examination of the voice box, with no alternative treatment suggested.

The submandibular glands, located under the jaw bone, produce saliva.

Blockages, often caused by stones or duct narrowing, can lead to painful swelling.

Investigations include X-rays, sialogram, ultrasound, and fine needle aspiration.

Surgery may be recommended based on the severity of the condition.

Stones causing gland swelling can be removed through the mouth under local or general anesthesia.

Gland Removal:If stones cause persistent inflammation, gland removal may be advised for long-term relief.

Lump Removal:

If a lump is suspected to be cancerous, removal of the entire gland helps in diagnosis.

The Procedure:

• Performed under general anesthesia with an small incision below the jaw.
• Duration: Approximately one hour.
• A drain is placed to prevent blood clot collection.
• Hospital stay: 24-48 hours post-operation.

Possible Complications:

• Hematoma (clot) occurs in up to 5% of patients, may require additional surgery.
• Wound Infection: Uncommon but treated with antibiotics; drainage may be needed.
• Facial Weakness: Very Rare, associated with nerve damage, usually temporary.
• Numbness: Temporary numbness around the wound, potential numbness of the face, ear, or tongue.
• Injury to Tongue Nerve: Unlikely but may cause temporary tongue numbness.
• Dry Mouth: Unlikely to experience significant dryness.
• Recovery: Return to work: 2 weeks off recommended.

The parotid gland, located in front and below the ears, produces saliva, with two glands on each side.

Lumps in the parotid can result from abnormal overgrowth, often benign but occasionally cancerous.

Reasons for Lump Removal: Although most lumps are non cancerous, removal is recommended due to potential growth, cosmetic concerns, and the risk of malignancy over time.

Parotidectomy Operation: Surgical removal of part or all of the parotid gland performed under general anesthesia.

-An incision from in front of the ear down to the neck is made, typically healing well with minimal scarring. This is same incision used for face lift surgery so cosmetically very safe.

A drain is placed to prevent blood clot collection.

Hospital stay: 24-48 hours post-operation.

Possible Complications:

• Facial Weakness:Facial nerve damage can lead to temporary or, rarely, permanent weakness.
• Numbness:Temporary numbness of the face and potentially permanent numbness of the ear lobe.
• Hematoma occurs in about 5% of patients, may require additional surgery.
• Salivary Collection: Saliva leakage in 2-5% of patients, may require drainage with a needle.
• Freys Syndrome( Rare):Red, flushed, and sweaty cheek while eating due to nerve regrowth, treatable with antiperspirant.
• Recovery: Two weeks off work.

A thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck, and it plays a crucial role in regulating metabolism by producing thyroid hormones. There are different types of thyroidectomy procedures, each serving specific purposes. Here is an overview:

Total Thyroidectomy:

• Indication: Removal of the entire thyroid gland.
• Conditions: Thyroid cancer, large goiters, Graves' disease, or other conditions affecting the entire gland.
• Procedure: The surgeon removes the entire thyroid gland through an incision in the front of the neck.
• Postoperative: Patients may need lifelong thyroid hormone replacement therapy after a total thyroidectomy.

Subtotal or Partial Thyroidectomy:

• Indication: Removal of a portion of the thyroid gland, leaving some thyroid tissue intact.
• Conditions: Benign tumors, goiters, or specific thyroid conditions.
• Procedure: A portion of the thyroid is removed, preserving the remaining functional tissue.
• Postoperative: The remaining thyroid tissue may continue to produce thyroid hormones, reducing the need for lifelong hormone replacement.

Thyroid Lobectomy:

• Indication: Removal of one lobe of the thyroid gland.
• Conditions: Small tumors or nodules confined to one lobe.
• Procedure: Only one lobe of the thyroid is removed, leaving the other lobe intact.
• Postoperative: The remaining lobe continues to produce thyroid hormones.

Central Compartment Neck Dissection:

• Indication: Removal of lymph nodes in the central compartment of the neck.
• Conditions: Thyroid cancer with lymph node involvement.
• Procedure: In addition to thyroidectomy, nearby lymph nodes are removed to prevent the spread of cancer.
• Postoperative: Close monitoring for recurrence and further treatment as needed.

Preoperative Preparation:

• Evaluation: A thorough evaluation of thyroid function, imaging studies, and biopsy may be conducted before surgery.
• Medication Adjustment: Thyroid medications may be adjusted before surgery.
• Communication: Patients should communicate any allergies, medications, or medical conditions to the surgical team.

Postoperative Care:

• Pain Management: Pain medication may be prescribed to manage postoperative pain.
• Thyroid Hormone Replacement: For total thyroidectomy, patients will need lifelong thyroid hormone replacement therapy.
• Monitoring: Regular follow-up appointments and monitoring of thyroid function and calcium levels.

Risks and Complications:

• Bleeding: Risk of bleeding during or after surgery.
• Infection: Risk of infection at the surgical site.
• Injury to recurrent laryngeal nerve leading to hoarseness of voice which is temporary.
• Hypothyroidism: For total thyroidectomy, the patient will become hypothyroid and require replacement therapy.
• Damage to Parathyroid Glands: The parathyroid glands, which regulate calcium, may be inadvertently damaged during surgery.

Recovery:

• Hospital Stay: Typically, patients stay in the hospital for one to two days.
• Resume Activities: Most patients can resume normal activities within a few weeks.