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Dec 14

Do you use any kind of nerve monitoring device while performing each surgery? Why or why not?

There is no substitute for identifying the recurrent laryngeal nerve in the operating room using careful dissection. The nerve monitor device should not be used to identify or “map out” the nerve. She does use the nerve monitor at the end of the case to test the integrity or the function of the nerve in addition to visualizing your vocal cords with laryngoscopy before and after surgery to ensure the recurrent laryngeal nerves are functioning properly.

Dec 12

I’ve read there are often thousands of dollars in unnecessary tests done on thyroid surgery patients. How do you minimize this number? What tests are performed?

Dr. Kroeker minimizes the number of tests performed by following the American Thyroid Association guidelines in regards to working up thyroid nodules. Ultrasound of the thyroid is done in her office, as is an FNA (fine needle aspiration) of a nodule if it meets criteria. By doing these two studies on the same day of your visit with her, it is more convenient for you and saves unnecessary tests from being done. If you have not had your blood drawn to check your thyroid function tests, Dr. Kroeker will order this as well.

Dec 9

What is the surgical treatment plan when I have thyroid or parathyroid surgery?

The surgical treatment plan is very personalized for thyroid surgery. After looking at your thyroid and neck with ultrasound in her office, Dr. Kroeker may recommend a biopsy of a thyroid nodule or a neck lymph node. Based on these biopsy results, your thyroid function tests, risk factors for thyroid cancer, and symptoms, Dr. Kroeker will have a very personal discussion with you regarding the extent of thyroid surgery needed.

The surgical treatment plan for parathyroid surgery is to remove all abnormal parathyroid glands that are causing your hyperparathyroidism. This can mean removal of one, two, three, and sometimes three and a half parathyroid glands. Dr. Kroeker uses intraoperative PTH (parathyroid hormone) levels in the operating room while you are still under anesthesia to ensure that the level has dropped appropriately prior to finishing the case.

Dec 7

What thyroid, parathyroid, and head and neck conditions does Dr. Teresa Kroeker treat?

Thyroid conditions:

  • Evaluation of thyroid nodules: in-office thyroid ultrasound and biopsies done same day of visit if indicated
  • Thyroid cancer
  • Central and lateral neck dissections for metastatic and recurrent thyroid cancer
  • Nodules suspicious for cancer
  • Hyperthyroidism (including Graves’ disease)
  • Multinodular goiter with compressive symptoms
  • Intraoperative recurrent laryngeal nerve monitoring
  • Flexible laryngoscopy to assess vocal cords before and after surgery

Parathyroid conditions:

  • Hyperparathyroidism (adenomas or hyperplasia)
  • Persistent or recurrent hyperparathyroidism
  • Intraoperative monitoring of parathyroid hormone level

Head and Neck Surgery:

  • Salivary gland tumors: parotid and submandibular gland masses
  • Persistent lymph nodes in neck
  • Thyroglossal duct cysts
  • Branchial cleft cysts
  • Schwannomas
  • Lipomas