There are usually 4 parathyroid glands adjacent to the thyroid gland, which control the calcium level in the bloodstream by releasing the parathyroid hormone (PTH). The vocal cord nerve (recurrent laryngeal nerve), which is responsible for the movement of the vocal cords, runs directly behind the thyroid gland on both sides.
Diagnosis and surgical treatment of hyperthyroidism (hyperthyroidism)
Hyperthyroidism is the term used to describe an overactive thyroid gland with excessive production of thyroid hormones. This leads to symptoms of an over-activated metabolism with sleep disorders, nervousness, hair loss, increased sweating, diarrhea and palpitations. The most common causes are Graves’ disease (autoimmune disease) or a hormone-producing nodule (autonomic adenoma). The diagnosis of hyperthyroidism includes a blood test with determination of thyroid hormones and possible antibodies, an ultrasound examination and a scintigraphy. For the treatment of hyperthyroidism, we work closely with our colleagues in endocrinology and nuclear medicine. The treatment options are discussed at the interdisciplinary thyroid board and tailored to the patient.
Diagnosis and surgical treatment of benign thyroid nodules / goiter
Nodular changes in the thyroid gland are very common and increase with age. These lumps are often detected by chance during an ultrasound examination of the neck or a tomographic imaging to clarify another disease in the neck area. Less frequently, they are noticeable due to their increasing size with swallowing problems or compression of the airways with a foreign body sensation or hoarseness. Depending on the size of the lump, a fine needle aspiration is performed to obtain a tissue sample for further clarification. Benign thyroid nodules can be checked with ultrasound if there are no symptoms. In the event of complaints or abnormal cells in the puncture, the case is discussed at the interdisciplinary thyroid board in order to evaluate the best therapy for the patient. If a malignant nodule is suspected, removal is recommended (hemithyroidectomy). Thermal ablation can be a good treatment option for benign lumps. The options are discussed on an interdisciplinary basis at the thyroid board and then discussed with the patient.
Treatment of malignant thyroid tumors
If there are malignant findings in the fine needle aspiration of the thyroid gland, surgery with removal of the affected lobe (hemithyroidectomy) or the entire thyroid gland (total thyroidectomy) is recommended, depending on the type and size of the tumor. If lymph node metastases are detected, the affected cervical lymph node areas are also removed. Based on the results of the tissue examination, the need for follow-up treatment with radioiodine therapy is discussed at the interdisciplinary thyroid board after the operation. In rare cases, additional radiation or chemotherapy is necessary.
Diagnosis and surgical treatment of parathyroid hyperfunction (hyperparathyroidism)
If the parathyroid gland is overactive, too much parathyroid hormone (PTH) is produced, which causes the calcium level in the blood to rise. The most common complaints are fatigue, stomach problems, osteoporosis or kidney stones. This is usually caused by a benign tumor of the parathyroid gland (adenoma). More rarely, the cause of hyperthyroidism is chronic kidney disease or a malignant tumor of the parathyroid glands. The clarification is similar to the clarification of hyperthyroidism with a blood test with determination of blood salts and parathyroid hormone, as well as ultrasound examination, scintigraphy and further nuclear medical clarification (SPECT, choline PET-MRI). We work closely with our colleagues in endocrinology and nuclear medicine to diagnose and treat hyperparathyroidism. The treatment options are discussed at the interdisciplinary thyroid board and individually tailored to the patient.
