Parathyroid Surgery
Parathyroid Surgery
The parathyroid glands are one of the endocrine glands, which make hormones to regulate physiological functions in your body. They regulate the balance of calcium in the body. Other endocrine glands are the thyroid glands, the pituitary, the adrenal glands, the pancreas, the testes, and the ovaries.
There are usually four pea size parathyroid glands. They are located in the neck behind the thyroid gland.
Hyperparathyroidism means overactivity of the parathyroid gland(s). This can abnormally raise the blood’s calcium level (hypercalaemia).
Parathyroid adenoma is a single overactive and enlarged parathyroid gland causing hyperparathyroidism. This is a benign or non-cancerous tumour.
Hypercalcaemia can manifest clinically with kidney stones, bone pain, osteoporosis and fractures without trauma, constipation, pancreatitis, stomach ulcers, fatigue and depression.
Hypoparathyroidism means under activity of the parathyroid gland(s). This abnormally lowers the blood’s calcium levels (hypocalcaemia).
The diagnosis of hyperparathyroidism is generally confirmed using lab tests. The abnormal parathyroid gland and its location is also identified prior to the surgery.
Parathyroidectomy is the removal of one or more of the parathyroid glands. It is performed under general anaesthesia.
Patients with kidney failure usually require the removal of all the parathyroid glands.
The surgeon makes an incision in the front of the lower neck where a tight-fitting necklace would rest. The surgeon then mobilises the thyroid gland to identify and remove the parathyroid gland or glands with the disease. At the same time precaution is taken to identify and preserve the recurrent laryngeal nerve(s). The nerves that lie very near to the thyroid and parathyroid glands and serve the larynx or the voice box.
The diagnosis may be confirmed by sending the gland(s) to the pathology department for immediate microscopic examination (frozen section). A drain (a soft plastic tube that drains fluid out of the area) may be placed before the incision is closed. The incision is usually closed with sutures (stitches). A dressing may be placed over the incision and the drain, if one is used.