The patient is rendered euthyroid prior to surgery to avoid subsequent thyrotoxic crisis. Antithyroid drugs are taken for 2-3 months and stopped about 2 weeks before the operation. The patient then takes potassium iodide to reduce the vascularity of the thyroid gland. The precise schedule depends on the surgeons own preference. About seven eighths of the thyroid is removed.
Laryngoscopy is required pre-operatively to demonstrate normal vocal cord function and remove any uncertainty about the aetiology of any loss of function. Even when there is no macroscopic damage there may be a qualitative change in the voice post operatively.
The procedure is curative but the choice lies with the patient who should be fully informed of the possible complications and the need for time-off for the operation.
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