The thyroid gland is located in the neck in front of the voice box. This butterfly shaped organ controls metabolism and is regulated by hormones. The thyroid gland is important to carry out vital body functions like maintaining the breathing rate, heart rate, body temperature and body weight. The occurrence of nodules in the thyroid gland is common but more prevalent in females than males especially those over 60 years of age. Thyroid nodules are abnormal overgrowths of tissues in the thyroid gland. These are generally benign in nature, but in rare instances, it could become cancerous too.
If you suspect that you have thyroid nodules, then it is best to seek a medical consultation. The ENT Clinic helps to evaluate your thyroid conditions and has the latest diagnostic methods to check the malignancy of the thyroid nodules.
What are the causes of thyroid nodules?
There are many reasons behind the origin of thyroid nodules and some of the most common reasons include:
Overgrowth of normal thyroid tissues: Nodules can form when there is an overgrowth of normal thyroid tissues. When it is larger in size, it can become bothersome. Some of these overgrowths are thyroid adenomas which can lead to hyperthyroidism.
Multinodular Goitre: This is when a bulge appears in the neck region. It could be due to hyperthyroidism or can be caused due to iodine deficiency. In the case of a multinodular goitre, there are many distinct nodules within the goitre.
Thyroid Cancer: The prevalence of thyroid cancer is increasing, and a thyroid nodule may develop into a malignancy. Early detection can lead to high long-term survival rates. Some of the common symptoms present include hoarseness in voice, neck discomfort and enlarged lymph nodes. This cancer can affect both young and old and is more common in women over 30 years of age.
Thyroiditis: Hyperthyroidism can lead to this condition too. This is when there is inflammation in the thyroid and is associated with abnormal thyroid functions. When there is chronic inflammation in the thyroid, it can result in enlarged nodules.
Thyroid cysts: These are fluid-filled cavities in the thyroid. These are a result of thyroid adenomas which are degenerating. These are generally benign but occasionally, it can have cancerous cells.
How do you know if you have thyroid nodules?
Generally, most of the thyroid nodules are symptomless. However, large nodules are visible at the base of the neck and it can be felt. They may also cause difficulty in breathing and swallowing. When these nodules are present, it can cause additional thyroxine to be secreted, which leads to unexplained weight loss, increased sweating, irregular heart beats and nervousness. Although most of the nodules are benign, there are instances where nodules are cancerous, thus determining it is important.
Can thyroid nodules bring complications?
At times it may lead to certain complications like difficulty in breathing and swallowing, hyperthyroidism and complications arising due to hyperthyroidism like an irregular heartbeat and weak bones.
When should you seek medical intervention?
At any time if you experience a sudden loss in weight, or have trouble sleeping, irritability, or irregular heart beats then you should seek medical intervention immediately. In addition, hypothyroidism symptoms like memory deficiency, depression and lethargy need to be investigated.
How are nodules diagnosed by ENT doctors?
The main aim of the ENT physician is to rule out cancer and to know if your thyroid is functioning well. A physical examination will be performed. The doctor will check to see if the patient is able to swallow properly and check for signs of hyperthyroidism. In addition, if needed the ENT would order a thyroid function test to check your hormone levels. An ultrasound scan may be done to determine if you have a single nodule or a cluster of nodules. The doctor may also be able to distinguish if it is a solid tumour or if it is filled with fluid. The most common way to rule out cancer is to do a fine-needle aspiration biopsy. It is a quick procedure that takes about 20 minutes and the samples are sent to the laboratory to be examined under a microscope. Another way to evaluate the thyroid nodules is by doing a thyroid scan. In this procedure, radioactive iodine isotopes are injected into the vein. It helps to distinguish between cancerous and non-cancerous cells.
What are the treatment options for thyroid nodules?
Your ENT doctor would advise you to have frequent observations for noncancerous nodules. This will be through physical examinations and blood tests. If the thyroid hormones are secreted in less amounts, then the ENT doctor would recommend a thyroid hormone therapy. In addition, for large thyroid nodules, it would be necessary to have surgery if the presence of the nodules are causing difficulty in breathing and swallowing. Individuals who have multinodular goiters where the airways are constricted would be advised for surgery. Indeterminate nodules too would need surgical removal.
Nodules caused due to hyperthyroidism
Nodules caused due to hyperthyroidism can be treated using radioactive iodine. This radioactive iodine can be taken as a liquid or capsule which can be absorbed by the thyroid gland. This way the symptoms of hyperthyroidism would subside, and the nodules would shrink. Medications like methimazole act as anti-thyroid treatment, helping to reduce the symptoms of hyperthyroidism. If the above treatment is not working, then surgery is the option to remove an overactive thyroid nodule.
The most common treatment option for cancerous nodules is surgery. Very small cancers have a very low risk of growing, so your ENT doctor will make a decision if to observe it further through ultrasound monitoring and blood tests or perform a surgery. Today only half of the thyroid may be removed depending on the extent of the cancer, while in the past thyroidectomy was a frequent option. Precision surgery is needed by expert hands to reduce any damage to vocal cords or parathyroid glands. One of the latest techniques to treat small malignant nodules is alcohol ablation. This technique uses the injection of small amounts of alcohol to destroy thyroid nodules through a series of treatment sessions.