Thyroidectomy (Hemi and Total)
Removal of part or all of the thyroid gland for nodules, goitre or malignancy, with identification and preservation of the recurrent laryngeal nerve and parathyroid glands as a central objective of the operation.
Head & Neck Surgery
Head & Neck
Surgery of the thyroid, salivary glands and neck — including assessment of neck lumps, with careful attention to the nerves that govern voice, facial movement and swallowing.
The neck is densely packed with structures that matter: the nerve to the vocal cord runs directly behind the thyroid, the facial nerve passes through the parotid gland, and the parathyroid glands that regulate calcium are the size of a grain of rice and sit against the thyroid capsule. Head and neck surgery is therefore as much about what is preserved as what is removed. Dr. Satish Babu performs thyroid and salivary gland surgery and assesses neck lumps, working within the multidisciplinary setting of a tertiary hospital where pathology, radiology and oncology input is available. A great many neck lumps turn out to require no surgery at all — but they do require a diagnosis.
How Neck Lumps and Thyroid Nodules Are Assessed
Most neck lumps in adults fall into three broad groups: inflammatory (reactive lymph nodes from infection), congenital (such as thyroglossal or branchial cysts), and neoplastic (benign or malignant). Assessment follows a standard sequence — history and examination, then ultrasound, then a fine needle aspiration cytology (FNAC) where indicated, which samples cells through a fine needle to establish the nature of the lump before any decision about surgery. Thyroid nodules are extremely common, particularly in women, and the great majority are benign; ultrasound characteristics and FNAC together determine which need removal and which can simply be monitored. Thyroid function tests establish whether the gland is over- or under-active, which is a separate question from whether a nodule is present. For salivary gland swellings, the distinction between a stone obstructing a duct, an infection, and a tumour changes the management entirely — and again, imaging and cytology settle it before an operation is contemplated.
See a specialist if
Symptoms That Should Be Assessed
- A lump in the neck that has persisted beyond three to four weeks
- A swelling in the thyroid that is enlarging or visibly asymmetric
- Swelling below the jaw or in front of the ear, particularly if it worsens with eating
- Difficulty or discomfort on swallowing
- A change in voice alongside a neck swelling
- Unexplained weight loss, night sweats or persistent fever with a neck lump
- Facial weakness accompanying a swelling near the ear
- A neck lump in a smoker or a patient with prior head and neck cancer (needs prompt assessment)
Diagnosed and managed here
Conditions Treated
- Thyroid nodules and multinodular goitre
- Thyroid cancer
- Hyperthyroidism requiring surgical management
- Parotid and submandibular gland tumours
- Salivary gland stones and chronic sialadenitis
- Thyroglossal and branchial cysts
- Cervical lymphadenopathy requiring biopsy
- Benign and malignant neck masses
- Parathyroid disease
What is involved
Procedures Performed
Parotidectomy
Removal of parotid gland tumours with dissection and preservation of the facial nerve, which passes directly through the gland and governs movement of the face.
Submandibular Gland Surgery
Excision of the submandibular gland for tumours, chronic infection or stone disease that has not responded to conservative measures.
Salivary Duct & Stone Management
Management of salivary stones, including duct-preserving approaches where feasible, so that gland function can be retained rather than the whole gland removed.
Neck Lump Excision & Biopsy
Excision of congenital cysts and diagnostic biopsy of persistent cervical lymphadenopathy where cytology has not provided a definitive answer.
FNAC & Ultrasound-Guided Assessment
Fine needle aspiration cytology with ultrasound guidance to characterise a lump before surgery is considered — the step that determines whether an operation is needed at all.
Before You Agree to an Operation
When Head & Neck Surgery May Not Be Needed
A neck lump is alarming, and that alarm can lead to surgery being sought before a diagnosis is established. In practice a large share of neck and thyroid findings are managed without an operation.
- Reactive lymph nodes from a throat or dental infection are the commonest cause of a neck lump and settle on their own once the infection resolves.
- Most thyroid nodules are benign. Where ultrasound features are reassuring and cytology is benign, the standard approach is periodic monitoring rather than removal.
- A small, stable, benign thyroid nodule causing no pressure symptoms and no cosmetic concern can reasonably be left alone and observed.
- Hyperthyroidism is often managed medically or with radioiodine. Surgery is one option among several, not the automatic route.
- Salivary stones can frequently be managed with hydration, gland massage, sialogogues and duct-preserving techniques, without removing the gland.
- Acute salivary gland infection is treated with antibiotics and hydration first; operating on an acutely infected gland is avoided.
- An incidental thyroid nodule found on a scan done for another reason is a common finding and usually needs characterisation, not excision.
- The exception: a hard, fixed, or progressively enlarging neck lump, or one with voice change or unexplained weight loss, needs prompt investigation rather than observation.
Common questions
I have a thyroid nodule. Does it need to be removed?+
Most likely not. Thyroid nodules are very common and the substantial majority are benign. The decision rests on ultrasound characteristics and, where indicated, fine needle aspiration cytology. Removal is generally advised where cytology is suspicious or malignant, where the nodule is large enough to cause pressure on the windpipe or oesophagus, where it is causing overactivity of the gland, or where it is enlarging on follow-up. A small benign nodule causing no symptoms is usually monitored with periodic ultrasound.
Will thyroid surgery affect my voice?+
The recurrent laryngeal nerve, which supplies the vocal cord, runs immediately behind the thyroid gland, so voice change is the principal risk of thyroid surgery. In experienced hands permanent voice change is uncommon, and identifying and preserving the nerve is a routine and deliberate part of the operation. Temporary hoarseness from handling or swelling around the nerve is more common and usually recovers over weeks to months. Voice is assessed before surgery so that any pre-existing change is documented.
Will I need thyroid medication after surgery?+
If the entire thyroid is removed, lifelong thyroid hormone replacement is required, taken as a single daily tablet with periodic blood tests to adjust the dose. If only one lobe is removed, the remaining lobe frequently produces enough hormone on its own, and many patients need no replacement at all — though thyroid function is monitored afterwards to confirm this.
Is a lump near my ear always serious?+
No. Swellings in the parotid region have a range of causes including infection, stones obstructing the duct, and benign tumours, which are considerably more common than malignant ones. The features that increase concern are rapid growth, pain, a hard fixed lump, and any weakness of facial movement. Assessment with imaging and cytology establishes the diagnosis before any decision about surgery.
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