Advanced Thyroid Center of Kentucky and Southern Indiana
Advanced ENT is Louisville’s most comprehensive center for thyroid and parathyroid surgical evaluation. Our board certified head and neck surgeons are trained in minimally invasive techniques for diagnosis and treatment of thyroid disease and cancer. Our office is the only head and neck surgery practice in Louisville, equipped with ultrasonography performed by the actual treating surgeons instead of technicians. This provides information unobtainable to surgeons who must base their decisions on a second-hand report. Our surgeons are trained in minimally invasive ultrasound-guided fine needle aspiration techniques. Specimens are sent to a nationally renowned lab known for inventing the national standard for thyroid cytopathologic diagnosis. This is a big advantage that leads to much more accurate treatment, reducing unnecessary surgery dramatically. Because these tests are performed in the office instead of a hospital, the cost can be significantly less.
Should surgery be necessary, our surgeons are trained in the latest techniques including video assisted thyroidectomy, minimal incision thyroidectomy, and nerve monitoring techniques used to treat thyroid and parathyroid disease in both adults and children. As a bonus, we are well-trained in facial plastic and reconstructive techniques providing a much more esthetic result than standard surgical techniques.
We study and follow the latest international guidelines agreed upon by international specialists. In this case, comprehensive evaluation and treatment performed every step of the way helps to provide the most appropriate treatment with the best results. With your neck on the line, why take chances? Pick a comprehensive center capable of addressing every necessary decision.
The thyroid gland, which controls metabolism and growth, is located beneath the Adam’s apple. Thyroid diseases are very common, affecting millions of Americans. A healthy thyroid is important because it helps to regulate and control the rate of physiological functions in your body. Signs of an underactive thyroid gland, or hypothyroidism, include puffy eyes or gradual forgetfulness, changes in hair (sparse, coarse, dry) and skin (coarse, dry, scaly).
Symptoms of an overactive thyroid gland, or hyperthyroidism, are goiter (enlargement of the thyroid gland), bulging eyeballs, fast heart rate, moist skin, frequent bowel movements, tremor, jumpiness, sensitivity to heat, and insomnia.
Both conditions can be treated with medications. Sometimes with hyperthyroidism, radioactive iodine is used to slow down the thyroid when medications cannot be taken. If surgical removal of the thyroid is required, the patient should be on hormone replacement pills for rest of his/her life.
While the entire thyroid gland may be enlarged in certain disorders, there may also be other situations where discrete, localized growths in the thyroid gland occur. These can be malignant and sometimes require removal. Most thyroid cancers can be removed and typically there is a long survival rate. There are exceptions, however, and certain thyroid cancers have the same lethal potential for spread as do other cancers.
Lumps in the thyroid gland may appear gradually or very rapidly, and can either be benign or malignant. All thyroid “lumps” (nodules) should generate suspicion and a prompt visit to the doctor. Patients who had radiation to the head and neck as children for acne, adenoids, or other reasons are more prone to develop thyroid cancer later in life. Most lumps are benign and usually treated with medication known as “suppression” therapy to shrink the lump.
In many cases, the thyroid mass will be removed. Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital or surgery center, and general anesthesia is usually required.
When choosing a doctor for this surgery, a patient should look for someone who often operates in the area and understands the complexities of thyroid endocrine conditions. There are two primary reasons. First, the nerves to the voice box go just underneath, and these need to be preserved. If these are damaged, the patient will have voice changes. Second, the important glands that regulate calcium metabolism are often attached to the thyroid and must be protected. Finally, a doctor must know how to look at vocal cords before surgery to know if there’s already a problem with the nerves. For these reasons, you need to see an otolaryngologist-head and neck surgeon.
In thyroid nodules, several risk factors tend to point to the possibility of malignancy:
- Age: Although thyroid cancer occurs in people of all ages, it is more common in younger people. In the elderly, however, the prospect for recovery is worse. Men over 40 and women over 50 have a poorer prognosis.
- Gender: Thyroid disease is common in women, but thyroid cancer is more common in men. At all ages, women also have better survival rates.
- Irradiation: Malignancy rate in thyroid nodules in those with a history of irradiation is about half. For that reason, patients who have had low-dose external beam radiation to the neck should be watched for the development of thyroid nodules.
- Environment: In the United States, multinodular goiters are rare, while this is not true for regions in Europe, the Himalayas, South America, and the Middle East.
- Characteristics: Watch for hard, fixed, fast-growing nodules.
- Metastases: Metastatic lymph nodes in the neck and vocal cord paralysis indicate cancer.
- Pressure effect: Distortion of the windpipe from thyroid masses that compress the airway is cause for immediate surgical intervention.
Clearer images, confident diagnosis and accurate diagnosis are a key component of healthcare. Our LOGIQ is an advanced color doppler ultrasound system from GE Healthcare bringing superior diagnostic capability.
Radio Frequency Ablation
Up until now, the only treatment option for these bothersome nodules was surgical removal. If the nodule was on just one side, then a hemi-thyroidectomy or lobectomy could remove that half of the thyroid. If there were troublesome nodules on both sides, then a complete removal of the thyroid was needed. Today, Advanced ENT & Allergy is now offering a great alternative to surgery. This new procedure can shrink thyroid nodules without harming or removing normal thyroid tissue around it. The procedure is called radio frequency ablation, abbreviated RFA.