Evaluation of patients with thyroid nodules is an important part of our practice. We perform fine needle aspiration biopsy of thyroid nodules in the office, as this is the procedure of choice for making the diagnosis.

About 20% of these nodules will be malignant or suspicious for malignancy and these will require surgical removal of the affected thyroid lobe. If cancer is found, total thyroidectomy is usually necessary. Our Frequently Asked Questions page has more information about the risks and recovery involved in thyroid surgery.

We also evaluate and treat patients with elevated calcium levels and hyperparathyroidism. We are able to take advantage of the newest trend in endocrine surgery, which involves the use of a rapid parathyroid hormone assay intraoperatively while performing a neck exploration for hyperparathyroidism.

Serum levels are taken at the start of the operation and then again 5 and 10 minutes after the removal of an enlarged gland. The level should fall by greater than 50%, signifying that the offending adenoma has been removed. If the level does not decrease, it may indicate a double adenoma or four gland hyperplasia, thus the surgeon would proceed with further exploration.

This allows the surgeon to achieve a higher success rate than with “blind” removal of parathyroid glands. We perform this surgery using the rapid assay at Evanston Hospital, currently the only institution in our system where this technology is available.