This organ, located in front of the windpipe (trachea) and larynx in our neck, is an endocrine gland that releases the hormones it produces into the blood. Basically, two very important hormones that regulate the body's metabolism, T3 (Tri-iodo-thyronine) and T4 (tetra-iodo-thyronine / thyroxine), are produced in this gland.
T4 hormone contains one of the 4 iodine atoms it contains in the thyroid gland and It is transformed into the more effective T3 hormone by losing it in other tissues of the body. This hormone, which is also called the orchestra conductor of the body, has a very important regulatory effect on metabolism.
The functions of the thyroid gland, namely the production of thyroid hormones, are controlled by TSH (Thyrothyropin / thyroid-stimulating hormone) produced in the pituitary gland in the brain. The TSH hormone level in the blood is the value that gives us doctors the most information about the functions of the thyroid gland. TSH measurement is possible with an easy blood test performed in biochemistry laboratories.
The thyroid gland also produces a different hormone called calcitonin or thyrocalcitonin, which has an effect on bone metabolism and the level of calcium in the blood. The effects of this hormone are not as important as T3 and T4. In case of deficiency, serious symptoms do not occur. Four half-pea-sized parathyroid glands adjacent to the back surface of the thyroid gland are responsible for the production of a hormone called parathormone, which also regulates the blood calcium level.
There are basically two types of functional cells in the thyroid gland. Cells called follicular cells or thyrocytes are responsible for the production of T3 and T4 hormones. Parafollicular cells or C cells, which are present in much smaller amounts compared to follicle cells, are also responsible for the production of the calcitonin hormone.
The thyroid gland consists of parts called the right and left lobes and the isthmus section connecting them in the middle. Sometimes there is a small extension of thyroid tissue called the pyramidal lobe upwards from the isthmus.
The thyroid gland is located very close to some important structures of the neck. These are;
- Superior (upper) laryngeal nerve, which is partially responsible for the movement and tension of the vocal cords,
- Inferior (lower) laryngeal nerve (recurrent nerve), which is mainly responsible for the movement of the vocal cords.
- These are the parathyroid glands that secrete the hormone that regulates the calcium level in the blood.
This It is important to protect critical nerves and glands during surgery. Contemporary thyroid surgery techniques applied today are based on removing the thyroid gland while preserving these structures.
What are the important structures that must be protected during thyroid surgery?
1. Laryngeal Nerves
Superior Laryngeal Nerve
It is one of the two branches of the vagus nerve, one of the longest nerves of the body, going to the larynx. This nerve, which is located on the right and left sides, controls the cricothyroid muscle, which provides tension to the vocal cords and lengthens and shortens their length. If it is damaged or cut, no serious hoarseness is observed, but the patient has difficulty making high-pitched sounds and gets tired quickly.
This situation can cause problems, especially for people who perform professions where the voice is at the forefront.
Recurrent (Inferior) Laryngeal Nerve
Gene branch of the Vagus nerve. This nerve, which is located on the right and left side of the neck, controls other muscles of the larynx other than the cricothyroid muscle. If it is bruised, damaged or ruptured, serious hoarseness often occurs. If the case is a severe damage such as rupture, crushing, or burning with an electric tool called cautery, the hoarseness may be permanent and in this case, some laryngeal - vocal cord surgeries may be required in the future to correct it.
2. Parathyroid Glands
Four half-pea-sized parathyroid glands, located on the back surface or on the sides of the thyroid gland, are anatomical structures that have very important functions for the body. These glands secrete a hormone called parathormone into the blood.
This hormone has a very important function in regulating the amount of calcium in the blood. Hypocalcemia (lack of calcium in the blood) may cause symptoms such as numbness in the lips and fingertips, contractions and cramps in the hands, arms, and legs.
Especially after bilateral thyroid gland surgeries, even if the parathyroid glands are preserved, hypocalcemia (hypocalcemia) that can last for several days ( A period of low blood calcium may occur. During this period, calcium pills or injections can be administered to the patient.
During thyroid surgery, it is important to protect these glands along with the very thin veins that feed them. These glands and their functions Special surgical techniques are applied to protect their homes.
How is the thyroid gland examined?
The first step examination of the patient who comes with complaints about the thyroid gland is done manually.
Usually, after getting behind the patient, an attempt is made to understand the size and consistency of the thyroid gland, located in the front-lower part of the neck, and whether it contains lumps called nodules. Then, the level of thyroid hormones in the blood is often checked to obtain information about the functions of the thyroid gland.
Then, whether there is a nodule in the thyroid gland, if there is a nodule, the structure of the nodule and the risk of harboring a tumor are evaluated in detail with ultrasound.
p>
Read: 0
