The thyroid gland is located at the front of the neck, showing the breath, the food pipe and the proximity to the main veins. It is butterfly shaped and has left and right parts extending to both sides. The thyroid gland releases two hormones called T3 and T4. These hormones regulate metabolism and organ functions in the body. The work of the thyroid gland is also under the influence of the hormone called TSH, which is released from the pituitary gland of the brain.
By looking at the blood level of these hormones, it is possible to understand whether the thyroid gland works normally. Hyperthyroidism is called when it works hard, in cases of low activity, it is called hypothyroidism. 
The examination of the thyroid gland is performed manually, but ultrasonography is usually necessary to clearly understand the changes in its structure. If the nodule is detected, scintigraphy may be required. Tomography is used in rare cases (in the growth towards the rib cage).
Thyroid operations are performed in patients with cancerous or benign thyroid nodules, large thyroid gland (goitre), patients with overactive thyroid gland (hyperthyroidism), and many hormone-releasing thyroid glands. There are various thyroid operations that a surgeon can do. These;
1. Biopsy or lumectomy: A small part of the thyroid gland is removed by this surgical method. 
2. Lobectomy or hemithyroidectomy: This method removes the thyroidin half.
3. Removing the majority of the thyroid gland leaving a small amount of tissue: This can happen in two ways.
a) Subtotal thyroidectomy: A small amount of tissue is left behind on one side of the bilateral side.
b) Near-total thyroidectomy: Removal of the thyroid gland on one side, leaving 1 gram or 1 cm of tissue.
4. Total thyroidectomy: removal of the entire thyroid gland.
Near total and total thyroidectomy is the preferred and preferred method of surgery today. These operations have various thyroid diseases, each of which must be treated. The main risks of thyroid operations are injury to important organs close to the thyroid gland during surgery. These include in particular parathyroid glands (regulating blood calcium level) and injuries of the recurrent and external laryngeal nerves (which regulate the operation of the vocal tract). In addition, bleeding can be seen rarely after the operation of this vein-rich organ. After some very large goitre operations, respiratory problems related to softening of the breathing tube (tracheomalacia) may occur.
When a patient is offered thyroid surgery, the patients should ask the following questions:
1. Why is an operation required?
2. Are there other treatment options (alternatives) for the treatment of my disease?
3. How should I be examined before surgery?
4. How do I choose the surgeon to perform my surgery?
5. What are the risks of the operation?
6. How much of the thyroid gland will be removed?
7. From what steps will I pass after I have decided on the operation?
8. Will I be normal after surgery?

Why is an operation required?

The most important reason for the delivery of the patients to the surgery is the presence of a nodule in the thyroid gland and this decision is directly influenced by the fine needle aspiration biopsy which is often done from the nodule. Surgical intervention is usually recommended for the following needle biopsy results: 
1. Cancer
2. Possibility of cancer (follicular, Hurthle neoplasia)
3. Benign conditions: Surgery of benign nodules is usually performed in the presence of large nodules, when the nodule grows gradually or when it causes various complaints (pain, swallowing difficulty, pressure symptoms). In addition, surgical interventions are an important treatment option for diseases in which the thyroid gland works too hard and causes excessive secretion. Surgery is also an important method of treatment in patients with large goitre, in patients with multiple nodules, or in any type of goiter that causes complaints in the patient.

Are there other treatment options (alternatives) for the treatment of my disease?

Thyroid surgery is absolutely necessary in all patients with thyroid cancer or thyroid cancer. If there is no chance of thyroid cancer, there are other treatment options depending on the diagnosis. However, these options should be decided by talking to the patient and the physician. Radioactive iodine therapy can be used in elderly patients at a time when the operation of the thyroid gland is not working well.

How should I be examined before surgery?

As is the case for all other operations, a complete physical examination should be performed in the preoperative period, including the medical history of the patient, the history of the resection, and the cardiac examination in patients scheduled for thyroid surgery. ECG and pulmonary radiography examinations are usually performed in patients over 45 years of age or in patients with heart disease. Blood tests may be required in patients with hemorrhagic problems, and a pre-operative hormone assay may be required. Patients with altered tone, patients who have undergone previous thyroid surgery, are examined for voice signals (vocal cord) in the preoperative period. It is important that the nerves that move the voice wires are intact before surgery.

How do I choose the surgeon to perform my surgery?

In general, thyroid surgery should be performed by surgeons who are best suited to the subject, specially trained and regularly dealing with thyroid surgery. Patients also have to ask their doctors who recommend surgery for which center or which doctors they recommend to be operated on. The risk of complications that may develop after surgery is less if performed by surgeons operating on a certain number of patients during the year.

What are the risks of the operation?

Thyroid surgeon's most serious risks are:
1. Bleeding; May cause sudden respiratory distress.
2. Recurrent laryngeal nerve injury; It can cause permanent voice annoyance.
3. Damage of parathyroid glands; Damage to the glands that control calcium levels in the body can lead to a disorder called hypoparathyroidism.
These complications are often more common in those with advanced lymph node involvement or with retrosternal goiters, which are followed by thyroid surgeons, behind the breastbone and known as the internal goiter. Moreover, the fact that the surgeon who will perform the thyroid operation is not very experienced is the cause of complications. The risk of any complications in this surgery should be less than 2%. These rates, however, vary depending on the experience of the surgeon. Preoperative patients should receive informed consent from the surgeon that they will be operated on alternative treatment methods, risks and benefits of the operation.

How much of the thyroid gland will be removed?

Patients should talk about how to perform an operation with their surgeon, how much of the thyroid gland will be removed (partially or entirely), and why such an approach is needed. The commonly accepted approach for follicular-type papillary-type cancers is the removal of the entire patch near the stomach. Thus, it is accepted that patients can benefit more from radioactive iodine treatment that may be needed after surgery. In patients with large tumors, patients with medullary thyroid cancer require dissection of the larger lymph nodes. Thyroidectomy (removal of the thyroid gland) is a very effective and successful method for patients with large numbers of benign thyroid nodules and / or large goiters. In these patients, the thyroid gland may be working hard and releasing excess hormones. This condition is successfully controlled by surgical intervention. It is extremely successful in the results of hemithyroidectomy or lobectomy, ie partial surgical procedure, in patients with normal or multiple hormone secretion, unilateral nodules. In the case of Graves' disease or hyperthyroidism due to multiple nodules, it is the method applied by most surgeons, with one side completely removing the thyroid lobe and the other side partially in the side.

Will I be normal after surgery?

Yes, you will be able to do everything you can do before the operation, after the thyroid operation has passed the effects, ie after the convalescence period. In many patients, after thyroid surgery, hormone levels decrease and hypothyroidism develops. This condition is more frequent in surgical structures with the cause of thyroid cancer. In the postoperative period hormone replacement therapy is performed and the drug dose to be taken with TSH Controls is adjusted. Your doctor may also recommend radioactive iodine treatment in the time interval before the post-operative hormonal onset.