Total Thyroidectomy, ultrasound imaging and overview, complications

Ultrasound Imaging Findings and Indications for Total Thyroidectomy

In an adult patient who has undergone a total thyroidectomy, ultrasound imaging will show an absence of normal thyroid tissue in the thyroid bed, often replaced by hypoechoic or heterogeneous areas due to fibrous or scar tissue. Scar tissue can appear more echogenic, indicating fibrosis. Occasionally, small nodules of residual thyroid tissue might be detected. The carotid artery and trachea remain visible, but the thyroid gland itself is absent. Color Doppler imaging typically shows minimal to no vascular flow in the thyroid bed, except in cases where residual or recurrent thyroid tissue is present, which may display increased vascularity.

Total thyroidectomy is indicated for thyroid malignancies like papillary, follicular, and medullary carcinomas, large goiters causing compressive symptoms, multinodular goiters with suspicious nodules, hyperthyroidism unresponsive to other treatments, and recurrent thyroid cancer. It may also be performed for cosmetic reasons when goiters or nodules cause significant aesthetic concerns.