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Parathyroid Surgery

Parathyroid Surgery

PARATHYROIDECTOMY

Parathyroid surgery, also known as parathyroidectomy, is a surgical procedure performed to treat disorders of the parathyroid glands. This is primarily done to address hyperparathyroidism, a condition characterized by the overproduction of parathyroid hormone (PTH), which leads to elevated calcium levels in the blood.

Parathyroid Glands

The parathyroid glands are four tiny glands located in the neck behind the thyroid gland. They produce parathyroid hormone (PTH), which helps to regulate the level of calcium in the blood.

Calcium is an essential mineral that plays a role in many important bodily functions, including muscle contraction, nerve signaling, and bone health. PTH works to maintain calcium levels in the blood within a narrow range. If calcium levels fall too low, PTH triggers the release of calcium from the bones and increases the absorption of calcium from the intestines. If calcium levels rise too high, PTH inhibits the release of calcium from the bones and decreases the absorption of calcium from the intestines.

Vectorized image of the parathyroid glands.

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The parathyroid glands are very important for maintaining overall health and well-being. If the parathyroid glands produce too much or too little PTH, it can lead to a number of health problems.

Types

There are two main types of parathyroid surgery:

Minimally Invasive Parathyroidectomy

In many cases, hyperparathyroidism can be treated with minimally invasive surgery. The surgeon makes a small incision in the neck or uses endoscopic techniques to locate and remove the overactive parathyroid gland(s) while preserving the healthy ones. This approach often results in a shorter recovery time.

Bilateral Neck Exploration

In cases where the exact location of the overactive gland(s) is uncertain, a more extensive surgery called bilateral neck exploration may be necessary. During this procedure, all four parathyroid glands are examined, and the abnormal ones are removed.

Procedure

Parathyroid surgery is typically performed under general anesthesia. The surgeon makes a small incision in the neck, usually on one side near the thyroid gland. The parathyroid glands are carefully identified and examined. The overactive gland(s) are removed while preserving the healthy glands.

 

In some cases, the surgeon may implant a portion of a healthy parathyroid gland into another location in the neck to ensure continued production of PTH.

Recovery

Post-operation, most patients can go home on the same day as the surgery or the following day. Calcium levels are closely monitored post-surgery, as the remaining parathyroid glands may need time to adjust to their new function. Patients may experience some neck discomfort and should avoid strenuous activities during the initial recovery period.

Risks & Complications

As with any surgical procedure, there are potential risks and complications, including bleeding, infection, damage to nearby structures, and the risk of hypoparathyroidism (insufficient PTH production) if too many parathyroid glands are removed or damaged.

 

Parathyroid surgery is typically performed by experienced surgeons like an Ear, Nose, or Throat Doctor (otolaryngologist), often in collaboration with endocrinologists. The decision to undergo parathyroid surgery is based on a thorough evaluation of the patient's condition and should be discussed in detail with healthcare providers to ensure the most appropriate treatment approach is chosen.

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