Parathyroid Surgery

Parathyroid surgery, also called parathyroidectomy, is the surgical removal of one or more parathyroid glands. The parathyroid glands are four small glands present in your neck behind the thyroid gland. They secrete parathyroid hormone (PTH) which regulates the calcium levels in your body.

Indications

Parathyroid surgery is recommended for the treatment of:

• Hyperparathyroidism, a condition where one or more parathyroid glands become enlarged and secrete excess amounts of parathyroid hormone
• Tumors of the parathyroid gland

Pre-Surgical Preparation

You are required to undergo a complete medical checkup before your parathyroid surgery which includes blood tests and a head and neck scan. In case you are on blood thinning medications such as aspirin, you may be asked to stop them prior to your surgery.

Surgical procedure

Most general surgeons use an open approach while performing the parathyroid surgery. In general, the procedure involves the following steps:

• You are placed in the supine position on your back and administered general anesthesia.
• A small incision is made along the crease in your neck.
• Your surgeon moves aside the neck muscles and the thyroid gland to locate the parathyroid glands.
• The diseased gland or tumor is removed, and the incision is closed and covered with a bandage.

Postoperative care

Following the procedure, you will be transferred to the recovery room where your vital signs are monitored, including blood calcium levels. If they fall low, you may experience symptoms of hypocalcemia such as muscle cramping, tingling or numbness. These can be relieved by taking calcium supplements and, if needed, vitamin D.

Your doctor may also prescribe medications for pain relief to keep you comfortable.

You should avoid exposure of the neck incision to direct sunlight and getting it wet.

If you experience continuous tingling despite taking medications, you should contact your doctor for follow-up.

Activities such as walking and mild exercises are encouraged following surgery. Avoid lifting heavy weight and intense exercises for a few weeks.

You can resume work and driving when you feel comfortable.

You will be instructed to drink plenty of fluids and resume a balanced diet as tolerated.

You may need to stay in the hospital for a day or two post surgery before discharge home.

Risks and Complications

As with any surgery, risks and complications can occur. Parathyroid surgery may have the following risks:

• Side-effects of anesthesia

• Nerve injury
• Breathing difficulty
• Bleeding
• Blood clots
• Infection
• Low calcium levels

Summary

Parathyroid surgery is recommended for the treatment of hyperparathyroidism and parathyroid gland tumors. It is usually performed as an open surgery and is a relatively safe and effective option when conservative treatment measures have failed to relieve symptoms associated with parathyroid tumors or hyperparathyroidism.