WhatsApp
Make An Appointment
+65 6258 8638
Make An Appointment

Home > Conditions > ENT Thyroid

Thyroid Specialist in Singapore

Book Appointment

Thyroid Nodule Assessment by an ENT Thyroid Specialist in Singapore

If you have noticed a lump in your neck, difficulty swallowing, or voice changes, these may be related to a thyroid nodule. While many nodules are benign, proper evaluation by a thyroid specialist in Singapore is important to determine whether monitoring or treatment is required.

Dr Leslie Koh is an ENT thyroid specialist who evaluates thyroid nodules with a focus on accurate diagnosis, risk assessment, and appropriate management, including surgical care when indicated.

What is a Thyroid Nodule?

Thyroid nodules are abnormal growths or lumps that develop within the thyroid gland, a butterfly-shaped gland located at the base of the neck. These nodules are common and may be:

  • Solid or fluid-filled
  • Single or multiple
  • Small and asymptomatic, or large enough to cause pressure symptoms

While most thyroid nodules are benign, a small percentage may be associated with thyroid cancer. Proper evaluation by a thyroid specialist in Singapore is therefore crucial.

What are the symptoms of Thyroid Nodules?

Most thyroid nodules are non-cancerous, do not cause symptoms, and do not need treatment. However, when nodules are larger or located in certain areas, they may produce symptoms that require further evaluation. The nodules are often discovered incidentally during check-ups or imaging tests, but some people may notice changes themselves.

Noticeable lump in the neck

Some patients discover a lump while looking in a mirror, buttoning a shirt collar, or fastening a necklace. This is often the first sign that leads to medical review.

Difficulty swallowing or breathing

Larger nodules can press on the windpipe or oesophagus, leading to a “tickle in the throat,” trouble swallowing solid food, or a sensation of shortness of breath.

Hoarseness or voice changes

Rarely, if a nodule affects the nerve that controls the vocal cords, it may cause changes in voice quality or persistent hoarseness.

Neck discomfort or swelling

Some people may experience a feeling of pressure, fullness, or discomfort in the neck area. In uncommon cases, pain may extend to the jaw or ear.

Note: Most thyroid nodules are found incidentally during physical examinations or imaging studies for unrelated reasons. Evaluation by a doctor familiar with thyroid conditions in Singapore helps to distinguish harmless nodules from those that may require monitoring or treatment.

What Causes Thyroid Nodules?

Thyroid nodules are common and may develop due to a range of underlying factors affecting the thyroid gland. While most nodules are benign, evaluation by a thyroid specialist in Singapore is important to determine whether further investigation or treatment is required.

Causes

Most thyroid nodules are non-cancerous and may form due to overgrowth of normal thyroid tissue or the development of fluid-filled cysts. These nodules are often detected during a routine examination or thyroid ultrasound and may not cause symptoms.

Some patients develop multiple nodules within the thyroid gland, a condition known as multinodular goitre. These nodules may gradually increase in size over time and can sometimes cause visible neck swelling or a sensation of pressure.

Inflammatory or autoimmune conditions, such as thyroiditis, may lead to changes in thyroid tissue. In some cases, this may be associated with the development of nodules or irregularities within the gland.

A small proportion of thyroid nodules may be associated with thyroid cancer. Certain features identified on ultrasound or fine needle aspiration (FNA biopsy) may require closer evaluation by an ENT thyroid specialist or thyroid surgeon in Singapore.

Risk Factors

Having close relatives with thyroid nodules, goitre, or thyroid cancer increases the likelihood of developing nodules.

Thyroid nodules are more commonly detected in women than in men.

The chance of developing nodules rises with age, even if they remain symptomless.

Prior exposure of the head or neck to radiation, especially during childhood, may increase risk.

When to See a Thyroid Specialist in Singapore

Not all thyroid nodules cause symptoms, and some are found only during routine checks. However, there are certain situations where it is advisable to seek review from a thyroid specialist in Singapore for further assessment.

A visible or palpable lump in the lower part of the neck may be the first sign of a thyroid nodule. Some people notice it while looking in the mirror, fastening a necklace, or buttoning a shirt collar. Even if the lump is painless, it should be assessed to determine whether it is arising from the thyroid gland.

If a thyroid nodule becomes large enough, it may press on nearby structures in the neck. This can lead to discomfort when swallowing, a sensation of throat tightness, or shortness of breath, particularly when lying down. These symptoms warrant review for possible ENT thyroid involvement.

A change in voice that does not settle, especially hoarseness lasting more than a few weeks, should not be ignored. While there are many possible causes of hoarseness, thyroid nodules located close to the nerves supplying the voice box may contribute to these symptoms.

Some nodules remain stable over time, while others gradually enlarge. If a previously identified nodule appears to be growing, repeat evaluation may be needed. Follow-up imaging and clinical review help determine whether further testing or treatment should be considered.

In some cases, a thyroid nodule is discovered incidentally during ultrasound, CT, MRI, or health screening. Even when there are no symptoms, these findings may still require follow-up, depending on the size and appearance of the abnormality. A review with a thyroid specialist may help clarify the next steps.

How are Thyroid Nodules diagnosed in Singapore?

Doctors may use physical examination, blood tests, imaging, and biopsy to assess nodules. The choice of test depends on symptoms, clinical findings, and the appearance of the thyroid gland.

A doctor may feel the neck for lumps, check for swelling, and ask about symptoms such as difficulty swallowing or voice changes. Questions about any personal or family history of thyroid disease are also typically included.

  • Thyroid Function Tests (TFTs): Measure levels of thyroid hormones to determine if the gland is overactive or underactive.
  • Thyroid antibodies: May be checked to evaluate for autoimmune conditions such as Hashimoto’s thyroiditis or Graves’ disease.
  • Ultrasound: Provides detailed images of the thyroid, showing whether a nodule is solid, cystic (fluid-filled), or mixed. Features such as size, shape, and borders are also evaluated.
  • Thyroid uptake scan: Uses a small amount of radioactive material to identify whether a nodule is “hot” (producing hormone) or “cold” (not producing hormone).

A thin needle is used to take a small sample of cells from the nodule, which is then examined under a microscope by a pathologist. This is often considered a reliable method for assessing whether a nodule is benign or suspicious.

An ENT thyroid surgeon in Singapore may recommend further testing if results are unclear or if the nodule shows features that warrant closer examination.

Possible FNA Results

Benign (Non-cancerous)

  • This result occurs in up to 80% of biopsies.
  • The chance of overlooking a cancer with a benign report is generally less than 3%.
  • Benign nodules usually do not require removal unless they cause symptoms such as choking or difficulty swallowing.
  • Follow-up ultrasound scans are important, and a repeat biopsy may be needed if the nodule grows over time.

Malignant (Cancerous)

  • About 5% of biopsies reveal a malignant result, most often due to papillary thyroid cancer (the most common thyroid cancer).
  • A “suspicious for malignancy” result carries a 50–75% chance of cancer.
  • These findings typically require surgical removal of the thyroid.

Indeterminate / Atypical / Suspicious

  • Seen in up to 20% of cases, where the sample has enough cells but cannot be clearly classified as benign or malignant.
  • Follicular lesion: Cancer risk is around 20–30%. Diagnosis requires surgery, usually the removal of the thyroid lobe containing the nodule. If cancer is found, the rest of the thyroid may need to be removed.
  • Atypia / follicular lesion of undetermined significance: Usually carries a low risk of cancer, but surgical biopsy is often recommended for confirmation.

Inadequate Sample

  • Occurs in fewer than 5% of biopsies when ultrasound is used to guide the procedure.
  • This result means there were not enough cells for diagnosis, which is more common in fluid-filled (cystic) nodules.
  • Repeat biopsy or, in some cases, surgical removal may be required for further assessment.

What Complications Can Thyroid Nodules Cause?

Most nodules are harmless, but possible complications include:

Large nodules may press on the windpipe or oesophagus, causing discomfort, trouble swallowing, or a sensation of tightness in the neck.

Some nodules produce excess thyroid hormone, which may lead to symptoms such as rapid heartbeat, weight changes, or heat intolerance.

While most nodules are benign, a small proportion may turn out to be thyroid cancer and require further evaluation.

What Are the Treatment Options for Thyroid Nodules?

Treatment depends on the type and size of the nodule. While many nodules do not require intervention, others may require medication, ablation, or surgery, depending on their features and their impact on health.

Nodules that are benign on Fine Needle Aspiration (FNA) or too small for biopsy are often monitored with regular follow-up. Ultrasound imaging should be performed every 6–12 months to monitor any changes in size or appearance.

Antithyroid drugs may be prescribed if a nodule produces excess thyroid hormone. Beta blockers can be used to control related symptoms such as rapid heartbeat or tremors.

In overactive nodules, radioactive iodine may be used to shrink the nodules and reduce hormone production.

Minimally invasive methods such as Radiofrequency Ablation (RFA), Ethanol Ablation, or High-Intensity Focused Ultrasound may be considered for nodules that are symptomatic but not cancerous.

  • Surgery may be recommended for large nodules, those with suspicious features, or those causing symptoms such as difficulty swallowing or breathing.
  • Hemithyroidectomy (Lobectomy): Removal of one lobe of the thyroid.
  • Total Thyroidectomy: Removal of the entire thyroid gland.
  • Learn more about thyroid surgery, including recovery and follow-up care.

ENT Thyroid Surgeon: When Surgery is Required

Not every thyroid nodule requires an operation. Many can be monitored safely with clinical follow-up and imaging. However, there are situations where referral to an ENT thyroid surgeon may be appropriate.

Surgery may be considered when a nodule is causing ongoing symptoms such as neck pressure, swallowing discomfort, or visible swelling. In some cases, even if the nodule is benign, removal may be discussed if its size is affecting comfort or day-to-day function.

If biopsy findings suggest malignancy, or if thyroid cancer has already been diagnosed, surgery is often part of treatment planning. The type of surgery depends on the size of the lesion, the biopsy result, and whether one or both sides of the thyroid are involved.

The thyroid gland sits close to the windpipe, food pipe, and nerves related to the voice box. If a nodule or enlarged thyroid is compressing these surrounding structures, surgery may be needed to relieve pressure and address the underlying cause. In such cases, assessment by an ENT thyroid surgeon helps guide the discussion on suitable management.

What Are Some Risks Of Thyroid Surgery?

Complications of thyroid surgery are uncommon, and may include:

 

  • Infections of the wound and wound site
  • Bleeding from the wound site and surgical bed
  • Temporary hoarseness and throat discomfort
  • Injury to the surrounding structures such as the windpipe, foodpipe, and large blood vessels in the neck
  • Injury to the nerves supplying the voice box, which may result in a permanently hoarse voice and / or a deepening of the tone of the voice
  • Injury to glands which secrete calcium which are attached to the thyroid gland; this may result in low calcium levels requiring calcium supplementation

Meet Dr Leslie Koh

ENT Thyroid Specialist

ENT Specialist singapore

Dr Leslie Koh is an ENT thyroid specialist whose clinical practice includes the evaluation and management of thyroid conditions, including thyroid nodules. He works with patients who require assessment of neck lumps, thyroid-related symptoms, and conditions affecting the airway, voice, or swallowing.

As a thyroid specialist in Singapore, Dr Koh manages thyroid conditions from an otolaryngology perspective, with attention to anatomical, functional, and surgical considerations where indicated.

Clinical Background and Practice

  • Medical training and specialist accreditation in otolaryngology
  • Experience in hospital-based ENT and thyroid-related clinical practice
  • Assessment and management of thyroid nodules, neck masses, and related ENT conditions
  • Ongoing participation in professional development within Singapore’s medical community

Approach to Thyroid Care

Dr Koh’s approach to thyroid evaluation focuses on structured assessment and clear communication.

  • Careful clinical examination of the neck and thyroid region
  • Use of appropriate investigations to guide discussion and decision-making
  • Clear explanation of findings, options, and possible next steps
  • Consideration of observation, further testing, or surgical referral based on individual clinical findings

Patients seeking care for ENT thyroid conditions are assessed based on symptoms, examination results, and diagnostic findings, with management discussed in a measured and patient-centred manner.

FAQs about Thyroid in Singapore

A thyroid specialist in Singapore, particularly an ENT thyroid specialist practising at an ENT clinic in Singapore, is well-equipped to assess both the medical and surgical aspects of thyroid nodules. This includes evaluating structural changes in the neck, potential effects on swallowing or voice, and determining whether monitoring or further intervention is required.

No. Most thyroid nodules are benign. However, further tests such as an ultrasound and FNA biopsy help determine whether further action is needed.

This depends on how much of the thyroid gland is removed. Some individuals may require long-term thyroid hormone replacement therapy, especially after a total thyroidectomy.

Recovery time varies, but most individuals return to normal activities within 1–2 weeks. Full healing of the surgical site may take several weeks.

The cost of thyroid surgery in Singapore varies significantly based on whether you are a subsidised patient in a public hospital or a private patient.

Estimated Total Bill (Surgeon, Anaesthetist, & Hospital Fees)

  • Public Hospital (Subsidised): Typical Bill Range SGD $2,200 – $5,800
  • Public Hospital (Unsubsidised): Typical Bill Range SGD $8,500 – $15,000
  • Private Hospital: Typical Bill Range SGD $25,000 – $40,000+

Most thyroid nodules do not disappear completely on their own. Some cystic nodules may shrink over time, but most require observation with follow-up scans. Regular monitoring at an ENT clinic helps track changes.

You should consider a medical review if you notice a lump in your neck, develop hoarseness, or have difficulty swallowing. Persistent throat symptoms may also warrant consultation with a throat specialist in Singapore.

The fear of “losing your voice” is common because the recurrent laryngeal nerves (which control the vocal cords) sit directly behind the thyroid gland. However, total voice loss is extremely rare.

Table Of Content

Book a Consultation with a Thyroid Specialist in Singapore

If you have concerns about a thyroid nodule or thyroid-related symptoms, early evaluation can provide clarity and peace of mind. Consult Dr Leslie Koh, an experienced ENT thyroid specialist, for personalised assessment and management of thyroid nodules in Singapore. Book an appointment today for a comprehensive thyroid evaluation.
Make An Appointment
Home
Location
E-Mail
Call