Parathyroidectomy is the surgical removal of parathyroid glands. There are four parathyroid glands located at the back of the thyroid gland in the neck. The parathyroid glands produce parathyroid hormone (PTH), which controls the calcium levels in the body.
Parathyroidectomy is necessary for patients with hyperparathyroidism, a condition in which parathyroid glands produce too much PTH and increase the levels of calcium in the blood.
85-90% of patients with primary hyperparathyroidism have a single enlarged or abnormal parathyroid gland. This allows endocrine surgeons to perform a more limited and focused exploration or removal of the single abnormal gland through a 2-3 centimeter incision. This procedure is referred to as a “minimally invasive parathyroidectomy” and has the following advantages for patients:
Some patients are concerned about the scars on their neck after surgery. They can consider scarless parathyroidectomy, which is a technique used to remove enlarged parathyroid glands through oral incisions that eliminate the neck scars. This endocrine surgery technique leaves no visible scars on your neck.
The risks of the parathyroid surgery include:
1. Bleeding
Although rare, you may experience bleeding. This is the primary reason as to why you are asked to stay overnight in the hospital.
2. Recurrent Laryngeal Nerve Injury
This nerve controls your vocal cords. If the laryngeal nerve is injured, you will have a hoarse voice. There is only a 1% chance of permanent hoarseness and a 5% chance of temporary hoarseness.
3. Low Blood Calcium
The parathyroid glands control your blood calcium levels. If they are removed or injured during the surgery, your blood calcium levels can decrease. This is why it is necessary to take vitamin D and calcium supplements either temporarily or permanently as prescribed by your doctor.
Your surgeon may change your diet and medications prior to your surgery if required. You are asked to visit the anesthesiologist at least a week before your surgery for a preoperative check. During this appointment, they may perform a blood test or other tests to prepare you for the surgery. If you take blood-thinning medications, you must contact your physician to discuss whether it is necessary to stop taking these medications prior to your surgery.
You may go home the same day or your doctor may ask you to stay overnight in the hospital for observation depending on your health condition.
You can have someone stay with you overnight only if your doctor or hospital grants you permission.
The surgical incision is about 1 to 2 inches in length and is placed in the midline of the neck in a normal skin crease to minimize scars and their visibility.
In general, you will be able to return to work within 1-2 weeks.
You can expect your pathology results within 7 to 10 days. However, the time required to prepare your results may vary depending on the type of your surgery. Sometimes, special staining may be necessary, which can delay the results. Your pathology results will be discussed at your follow-up appointment after surgery unless indicated.
Contact our surgery center or general surgeon Anchorage to learn more about parathyroidectomy.