The thyroid gland is situated in the neck and can cause many problems if it becomes dysfunctional. Thyroid hormones are responsible for the regulation of metabolism and an over- or underactive thyroid can cause symptoms such as weight loss or weight gain, hair-loss, fatigue, hyper-excitability, poor concentration, mood disturbances, depression, aches and pains, and numerous other issues. If the thyroid becomes sluggish then the body may respond by enlarging the gland, thereby creating a goitre, or distinctive swelling of the neck. This can be painful, with patients also experiencing referred pain in the shoulders, and chest, and a sensation of pressure in the throat.
As the enlarged thyroid is usually dysfunctional and does not produce excessive amounts of thyroid hormone, this is called a non-toxic goitre. The swelling in the neck can cause vocal changes, such as a deepening, or huskiness, to the voice. Cancerous growths in the thyroid may also cause swelling and pain, but these are usually painless and identified as a result of an incidental scan; they are usually removed through surgery. Non-cancerous growths may be left untreated after confirmation through needle biopsy unless they become sizeable enough to cause pain, which is rare.
The Location of the Thyroid Gland
The thyroid gland lies just in front of (anterior to) the windpipe (trachea) and the larynx, below the thyroid cartilage (Adam’s Apple in men). The gland consists of two almost conical lobes and looks a little like a butterfly with a body called the isthmus connecting the two. As it wraps around the larynx and the trachea it can be problematic for these structures if it changes size or shape. It also impacts the oesophagus and the carotid sheath posteriorly to the larynx and trachea to which it is firmly attached. This attachment to the trachea and the cricoid cartilage is what makes it move when swallowing occurs. The cricopharyngeus muscle is connected to the thyroid gland by the posterior suspensory ligament of Berry. The recurrent laryngeal nerve, and the inferior thyroid artery pass next to the ligament, which can complicate surgery on the cervical spine for neck pain, or for specific thyroid disease.
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