The thyroid gland plays a vital role in regulating the body’s metabolism through the production of thyroxine hormone. However, when the gland develops abnormalities such as nodules or significantly elevated thyroglobulin levels, thyroid removal surgery or thyroidectomy is often recommended as the best treatment option. Although this procedure is highly effective, many patients worry about the potential risk of damage to the vocal cord nerves, which may affect their ability to speak or sing after surgery.
Fortunately, advances in medical technology now allow thyroidectomy procedures to be performed with a much higher level of safety. Mandaya Royal Hospital Puri stands as one of Indonesia’s leading thyroid centers by offering Intraoperative Neuromonitoring (IONM) technology, which enables surgeons to monitor vocal cord nerve function in real-time during surgery. This technology successfully preserved the vocal cord function of a patient named David from Central Jakarta, who recently underwent thyroid surgery at the hospital.
“As soon as I woke up from surgery, dr. Enos came to see me and asked me to sing in the Karo language. Then he asked whether I felt nauseous, had pain while swallowing, or had phlegm in my throat. I answered no to all of them,” said the patient.
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The Patient’s Journey Toward a Thyroid Diagnosis
David initially visited the doctor not because of thyroid-related complaints. He had a history of gallstones, gastric issues, and prostate problems, which led his doctor to recommend thyroid screening as part of a comprehensive medical examination. The results revealed a surprising finding: his thyroglobulin level had reached 1,096 ng/mL, far exceeding the normal range of around 70 ng/mL.
Further ultrasound examination revealed a 4 cm nodule in the right lobe of the thyroid gland, along with a smaller nodule on the left side. Considering the significant size of the nodule, the doctor immediately recommended thyroid removal surgery. This marked the beginning of David’s journey in searching for the most suitable medical treatment for his condition.
Seeking a Second Opinion and Considering Treatment Abroad
Before making a final decision, David and his wife decided to seek a second opinion. Encouraged by family members and colleagues, they considered undergoing treatment in Penang, Malaysia. Since David had four different medical conditions, they hoped to address all of them during a single medical trip.
However, after consulting with doctors there, surgery remained the only treatment option. Concerns soon arose about undergoing surgery abroad, as the recovery period could take up to 10 days, while taking such a long leave from work was not possible for the patient. Eventually, David and his family decided to proceed with surgery in Indonesia.
Choosing Mandaya Royal Hospital Puri as a Trusted Thyroid Center
The patient’s wife then conducted extensive research and identified four hospitals in Indonesia known for their thyroid services. Mandaya Royal Hospital Puri was among them and ultimately became their choice. This decision introduced David to a medical team that transformed his surgical experience into something far more reassuring than he had imagined.
At Mandaya Royal Hospital Puri, David met dr. Enos H. Siburian, Sp.B (K) Onk, a surgical oncology specialist, and dr. Eko Purnomo, Sp.KNTM (K) Onk, a nuclear medicine specialist. Both doctors are part of a multidisciplinary team consisting of various specialists, an approach that David greatly appreciated. He admitted that meeting several specialists in one session was far more efficient and comfortable compared to visiting multiple separate consultation rooms.
Like many patients preparing for thyroidectomy, David had one major concern: would his voice remain normal after surgery? As is well known, the thyroid gland is located very close to the recurrent laryngeal nerve, the nerve responsible for controlling vocal cord movement. Damage to this nerve may lead to permanent hoarseness or even loss of voice.
David openly expressed this concern to dr. Enos before surgery. The doctor reassured him that the procedure would be performed very carefully, prioritizing the preservation of the vocal cord nerves, parathyroid glands, and surrounding blood vessels. Moreover, dr. Enos personally visited David before surgery to offer prayers and comfort, helping the patient enter the operating room with greater peace of mind.
IONM Technology Helps Protect Vocal Cord Function During Surgery
One of the key advantages offered by Mandaya Royal Hospital Puri in thyroidectomy procedures is the use of IONM technology. This technology works by monitoring nerve conditions in real-time during surgery, allowing surgeons to immediately detect any potential nerve injury and take preventive action.
With IONM, surgeons do not rely solely on visual observation. The monitoring system provides an additional layer of safety, especially in complex anatomical cases or large tumors such as David’s. In this case, the procedure performed was a near-total thyroidectomy, involving complete removal of the right thyroid lobe and most of the left lobe while preserving vital surrounding structures.
The near-total thyroidectomy procedure involved removing the entire right lobe and most of the left lobe of the thyroid gland. The main indications were the presence of a nodule in the right lobe and an extremely high thyroglobulin level of 1,096 ng/mL. Throughout the operation, the medical team focused on preserving the vocal cord nerves, parathyroid glands, and important blood vessels with continuous support from IONM technology monitoring the nerves directly.
As early as the first day after surgery, David was already able to walk around his hospital room and practice walking independently. This was a remarkable achievement considering the complexity and scale of the procedure he had just undergone. His rapid recovery reflected not only the technical success of the surgery, but also David’s physical readiness and the quality of post-operative care provided by the medical team at Mandaya Royal Hospital Puri.
Voice Remained Intact After Surgery, Patient Was Able to Sing Immediately
The moment David had been waiting for finally arrived when he regained consciousness after anesthesia. dr. Enos immediately visited him and performed a simple test by asking him to sing. While this request may sound unusual, it is actually an effective way to quickly evaluate vocal cord function after thyroid surgery.
David was able to sing without any problems. In addition to his vocal cords functioning normally, he also did not experience other common complaints often associated with neck surgery, such as nausea, pain while swallowing, or excessive phlegm in the throat. These results serve as clear evidence that IONM technology, combined with the expertise of the experienced surgical team at Mandaya Royal Hospital Puri, can deliver safe and satisfying thyroid surgery outcomes.
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