Innovations in treating thyroid and parathyroid disease
After finishing his head and neck surgery fellowship at The Johns Hopkins Hospital in 2001, Ralph Tufano was interested in performing thyroid and parathyroid operations. He decided to stay and join the faculty, even though the head and neck division was performing only a handful of these procedures.
“I felt like I could really be part of a growing area,” he says, “and make a difference.”
Last year, Tufano, now director of thyroid and parathyroid surgery, and his colleagues performed more than 250 thyroid- and parathyroid-related procedures, an expansive growth he attributes to Johns Hopkins’ interdisciplinary approach. Although endocrinology, general surgery, and otolaryngology–head and neck surgery are separate departments at many hospitals, physicians from these specialties collaborate here to make sure patients get the best care.
Such close teamwork allows them to develop the best plan to tackle especially difficult procedures, such as reoperations when cancer recurs.
These surgeries can be incredibly complex, involving navigation around scar tissue from previous surgery. Tufano notes that the ability of the various specialist teams to pool their expertise is a draw for many cancer patients who need follow-up surgery.
“We probably do more reoperative procedures than any other place in the country,” he says.
The close collaboration also allows Johns Hopkins’ thyroid and parathyroid surgeons to offer some unique options to patients here. Recently, head and neck surgeons, including Jeremy Richmon and Department of Surgery colleagues Martha Zeiger and Alan Dackiw, began performing operations to remove diseased thyroids and parathyroids through incisions in a patient’s armpit instead of the traditional approach through the neck, which leaves a scar.
“We see the majority of thyroid problems in younger women,” Richmon says, “but sometimes those who are advised to have surgery are really reluctant to follow through because they know they’ll have a visible neck scar.”
The procedure is done endoscopically, he explains, by using a robot to place surgical tools through a tiny incision. Studies have shown that for select cases, patients do just as well with this type of procedure as they would have with traditional surgery.
Richmon anticipates that it’s just a stepping stone to more innovative “scarless” thyroidectomies and parathyroidectomies. In the future, he says, surgeons may make incisions in the mouth, leaving no visible scar at all.
With thyroid cancers on the rise, Tufano notes that such innovations have never been more necessary.
“We’re excited to develop these ideas,” he says, “and get new treatments out to patients with thyroid and parathyroid disease.”