Thyroid & Parathyroid surgeon

Dr Vyas Prasad, thyroid and parathyroid surgeon at Absolute ENT, Camden Medical Centre, Singapore

25+ years experience

500+ Google Reviews

ROYAL MARSDEN
HOSPITAL

GRAY'S INN ROAD
HOSPITAL

Thyroid & Parathyroid Surgery

Thyroid and parathyroid surgeries are precision procedures aimed at treating conditions such as nodules, goiters, cancer, and overactivity (hyperthyroidism or hyperparathyroidism). Dr Vyas Prasad brings over 25 years of surgical experience, including UK-based training at prestigious institutions like the Royal Marsden and Barts Health NHS Trust, to provide patients with the highest standard of care.

The thyroid gland plays a vital role in regulating the body's metabolism. When surgery is required—whether for a suspected malignancy or a symptomatic goiter—the primary goal is the safe removal of the affected portion of the gland while preserving critical surrounding structures. Dr Vyas Prasad specialises in minimally invasive thyroid surgery in Singapore, ensuring precise outcomes and minimal scarring. His dual expertise as a laryngologist provides critical protection for the voice nerve during complex procedures. He utilizes minimally invasive techniques where possible, focusing on smaller incisions, reduced post-operative discomfort, and faster recovery times.

A critical aspect of thyroid and parathyroid surgery is the protection of the recurrent laryngeal nerves, which control the vocal cords. As a specialist laryngologist, Dr Prasad has an intimate understanding of the vocal anatomy, allowing him to navigate these delicate nerves with exceptional precision. Intra-operative nerve monitoring is frequently employed as an added layer of safety to ensure voice function remains intact.

Parathyroid surgery typically involves the removal of one or more overactive parathyroid glands that are causing calcium imbalances in the body. Using localized imaging and minimally invasive surgical approaches, Dr Prasad ensures that these small but essential glands are managed effectively, restoring hormonal balance with minimal impact on the patient's daily life.

At our clinic, patient education and comfort are paramount. Each surgical plan is tailored to the individual, ensuring that patients understand their diagnosis, the surgical process, and the expected outcomes. Dr Prasad’s expertise ensures that the focus remains on long-term health, voice preservation, and aesthetic excellence.

Thyroid Conditions Managed

Thyroid Nodules

Thyroid nodules are very common — they are found in up to 50% of adults on ultrasound. The vast majority are benign, but a small proportion require further investigation or treatment. Most nodules are discovered incidentally on imaging performed for another reason, or felt as a lump in the neck.

Assessment of a thyroid nodule typically involves:

Thyroid ultrasound — to characterise the nodule's size, composition, and features that might indicate a higher or lower risk of malignancy
Fine-needle aspiration cytology (FNAC) — a quick, minimally uncomfortable procedure to sample cells from the nodule for laboratory analysis, recommended for nodules with concerning features
Thyroid function blood tests — to assess whether the gland is functioning normally
Further imaging (CT or nuclear medicine scan) in selected cases

Many nodules require no treatment beyond monitoring. Surgery is recommended when a nodule is confirmed or suspected malignant, is causing compressive symptoms, or is growing progressively despite observation. Click here to read more.

Goitre (Enlarged Thyroid)

A goitre is an enlargement of the thyroid gland, which may be diffuse (the whole gland is enlarged) or nodular (containing one or more nodules). It may cause a visible or palpable swelling in the neck, and in some cases a large goitre compresses the airway or oesophagus, causing difficulty breathing or swallowing.

Surgical removal (thyroidectomy) is considered when a goitre causes compressive symptoms, is cosmetically significant, or contains nodules that require histological assessment. The extent of surgery — removing one lobe or the whole gland — depends on the findings.

Thyroid Cancer

Thyroid cancer is among the most treatable of all cancers, particularly when detected at an early stage. The most common types — papillary and follicular thyroid cancers — have excellent long-term outcomes with appropriate treatment. Treatment usually involves surgical removal of part or all of the thyroid gland, sometimes followed by radioiodine therapy or thyroid hormone suppression.

Dr Prasad manages thyroid cancer surgery within a multidisciplinary framework, working alongside endocrinologists, oncologists, and nuclear medicine physicians to ensure patients receive coordinated, evidence-based care.

Overactive Thyroid (Hyperthyroidism) & Graves' Disease

An overactive thyroid produces excess thyroid hormone, causing symptoms such as palpitations, weight loss, heat intolerance, anxiety, and tremor. The most common cause is Graves' disease, an autoimmune condition. Other causes include toxic nodules and toxic multinodular goitre.

Treatment options include antithyroid medications, radioiodine therapy, and surgery. Thyroidectomy is a definitive treatment option for patients who prefer surgery, have a large goitre, or are not suitable candidates for radioiodine. Dr Prasad works closely with endocrinologists to ensure patients are appropriately optimised before any surgical procedure.

Anatomical diagram of the thyroid and parathyroid glands in the neck

Parathyroid Conditions Managed

Most people have four parathyroid glands — small glands sitting behind the thyroid — whose sole function is to regulate calcium levels in the blood. When one or more of these glands becomes overactive, it can cause significant health problems.

Primary Hyperparathyroidism

Primary hyperparathyroidism is the most common parathyroid condition and occurs when one or more glands produce excess parathyroid hormone (PTH), raising blood calcium levels. It is often detected incidentally on a routine blood test. When symptomatic, it can cause:

Kidney stones
Bone thinning (osteoporosis)
Fatigue, low mood, or cognitive changes
Abdominal pain, nausea, or constipation
Muscle weakness

The cause is most commonly a single benign overactive gland (parathyroid adenoma). Surgery — parathyroidectomy — is the only curative treatment and is highly effective. Localisation imaging (such as a sestamibi scan or 4D CT) is used to identify the overactive gland before surgery, allowing a targeted, minimally invasive approach in most cases.

Secondary & Tertiary Hyperparathyroidism

Secondary hyperparathyroidism occurs when all four parathyroid glands become overactive in response to chronically low calcium — most commonly due to kidney failure. Tertiary hyperparathyroidism develops when the glands remain overactive even after the underlying cause (such as a kidney transplant) has been treated. Surgical management involves removal of most or all of the overactive gland tissue.

About Thyroid & Parathyroid Surgery

Thyroidectomy

Thyroidectomy is the surgical removal of part or all of the thyroid gland. The extent of surgery depends on the underlying condition:

Hemithyroidectomy (lobectomy): Removal of one lobe of the thyroid. Used for single nodules, follicular lesions requiring histological diagnosis, or low-risk differentiated thyroid cancer. Thyroid function is often preserved.
Total thyroidectomy: Removal of the entire thyroid gland. Used for thyroid cancer, bilateral disease, large goitres, or Graves' disease. Lifelong thyroid hormone replacement is required afterwards.

The incision is placed within a natural skin crease in the lower neck, where it heals neatly and is often barely visible after a few months. Dr Prasad uses meticulous surgical technique to minimise the risk to the recurrent laryngeal nerve — the nerve that controls vocal fold movement — and to the parathyroid glands.

The Voice Nerve — Why a Laryngologist Matters

The recurrent laryngeal nerve runs in close proximity to the thyroid gland and controls the movement of the vocal folds. Injury to this nerve during thyroid surgery can cause hoarseness, a weak voice, or breathing difficulties. As a subspecialty laryngologist — a surgeon who also specialises in the voice — Dr Prasad has a particular understanding of the anatomy, function, and vulnerability of this nerve.

Intraoperative nerve monitoring is used during thyroid surgery to continuously assess nerve function throughout the procedure, providing an additional layer of safety. If any voice change occurs after surgery, Dr Prasad is also able to assess and manage this directly using laryngoscopy and voice rehabilitation.

Parathyroidectomy

Minimally invasive parathyroidectomy — guided by preoperative localisation imaging — allows removal of a single overactive gland through a small targeted incision, often under local or regional anaesthesia with sedation. Recovery is typically rapid, with most patients going home the same day or after one night. Where multiple glands are involved, a bilateral neck exploration is performed.

Recovery After Thyroid or Parathyroid Surgery

Most patients undergoing thyroid or parathyroid surgery stay one night in hospital and return to light activities within one to two weeks. Specific recovery guidance will be provided based on the procedure performed, but in general:

The neck wound heals well and is usually covered with a simple dressing or adhesive strips

Voice changes in the immediate post-operative period are common and usually settle within days to weeks as swelling resolves

After total thyroidectomy, thyroid hormone tablets are started promptly and levels monitored with regular blood tests

Calcium levels are monitored after total thyroidectomy, as temporary low calcium (due to parathyroid disturbance) can occur and is managed with supplements

Patients are reviewed at two to four weeks post-operatively and followed up with their endocrinologist as appropriate

Frequently Asked Questions

I have a thyroid nodule — does it need to be removed?

Not necessarily. The majority of thyroid nodules are benign and require only monitoring with periodic ultrasound. Surgery is recommended when a nodule has features suspicious for malignancy on ultrasound or FNAC, is causing compressive symptoms, or is growing significantly over time. Dr Prasad will review your imaging and cytology results and give you a clear recommendation based on the evidence.

Will thyroid surgery affect my voice?

Temporary voice changes after thyroid surgery are relatively common as a result of swelling and handling of the surrounding tissues. They almost always resolve within days to weeks. Permanent voice change from recurrent laryngeal nerve injury is uncommon in experienced hands, and the risk is reduced further with intraoperative nerve monitoring. Because Dr Prasad is also a laryngologist, any voice concern after surgery can be assessed and managed directly within the same practice.

Will I need to take medication after thyroid surgery?

After a hemithyroidectomy (removal of one lobe), most patients retain sufficient thyroid function and do not need thyroid hormone replacement, though this is monitored with blood tests. After a total thyroidectomy, lifelong thyroid hormone tablets (levothyroxine) are required. These are taken once daily and are very well tolerated once the correct dose is established.

How is a parathyroid adenoma found before surgery?

Localisation imaging is used to identify the overactive gland before a minimally invasive procedure. This usually involves a sestamibi nuclear medicine scan, a 4D CT scan, or neck ultrasound — and often a combination of these. Where imaging is inconclusive, a bilateral neck exploration is performed, which allows direct examination of all four glands.

Is thyroid cancer serious?

Most thyroid cancers — particularly papillary and follicular types — carry an excellent prognosis when treated appropriately. Ten-year survival rates for these cancers are very high. Medullary and anaplastic thyroid cancers are rarer and carry a more variable prognosis. The most important factor in outcome is early detection and appropriate surgical management.

What is the scar like after thyroid surgery?

The incision is made within a natural skin crease in the lower neck — sometimes called a "Kocher incision". It is typically five to eight centimetres in length and, with good wound care, heals to a fine, flat scar that fades significantly over six to twelve months. Many patients find the scar barely noticeable after a year.

How long does thyroid surgery take?

A hemithyroidectomy typically takes 60 to 90 minutes. A total thyroidectomy takes 90 to 120 minutes. Minimally invasive parathyroidectomy for a single adenoma can be completed in 30 to 45 minutes. All procedures are performed under general anaesthetic.

Book a Thyroid or Parathyroid Consultation in Singapore

Whether you have been referred following an incidental finding, are experiencing symptoms, or simply want a specialist opinion on a known thyroid condition, Dr Prasad offers clear, evidence-based assessment and surgical care.

Dr Vyas Prasad consults at Camden Medical Centre, 1 Orchard Boulevard, #09-08, Singapore. Contact the clinic by WhatsApp or phone to arrange an appointment.

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