- Thyroid cancer is present or is suspected.
- A noncancerous (benign) nodule is large enough to cause problems with breathing or swallowing.
- A fluid-filled (cystic) nodule returns after being drained once or twice.
- Hyperthyroidism cannot be treated with medicines or radioactive iodine.
- Total thyroidectomy. Your surgeon will remove the entire gland and the lymph nodes surrounding the gland. Both sections (lobes) of the thyroid gland are usually removed. Additional treatments with thyroid-stimulating hormone (TSH) suppression and radioactive iodine work best when as much of the thyroid is removed as possible.
- Thyroid lobectomy with or without an isthmectomy. If your thyroid nodules are located in one lobe, your surgeon will remove only that lobe (lobectomy). With an isthmectomy, the narrow band of tissue (isthmus) that connects the two lobes also is removed. After the surgery, your nodule will be examined under a microscope to see whether there are any cancer cells. If there are cancer cells, your surgeon will perform a completion thyroidectomy.
- Subtotal (near-total) thyroidectomy. Your surgeon will remove one complete lobe, the isthmus, and part of the other lobe. This is used for hyperthyroidism caused by Graves' disease.
- Hoarseness and change of voice. The nerves that control your voice can be damaged during thyroid surgery. This is less common if your surgeon has a lot of experience or if you are having a lobectomy rather than a total thyroidectomy.
- Hypoparathyroidism. Hypoparathyroidism can occur if the parathyroid glands are mistakenly removed or damaged during a total thyroidectomy. This is not as common if you have a lobectomy.