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Parathyroid Surgery

What are the Parathyroid Glands
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The parathyroid glands are located within the thyroid gland just below the voice box in your neck.

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Each of the four parathyroid glands (two each side of the neck) are oval shaped and are about the size of a pea.

 

The Parathyroid glands produce parathyroid hormone that help regulate the calcium levels in the body.

Precise calcium levels are important in the human body as slight changes in calcium levels can cause muscle and nerve problems.

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What happens when the parathyroid glands do not function properly

Parathyroid disorders (such as over-activity of the parathyroid glands called hyperparathyroidism) lead to abnormal levels of calcium in the blood that can cause:

  • Brittle bones

  • Muscle weakness

  • Fatigue and decreased alertness

  • Kidney stones

  • Frequent urination

  • Occasional joint discomfort.

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Hyperparathyroidism (high parathyroid hormone levels) can be due number of reasons. If not already performed, some blood tests and urine tests are required to confirm a diagnosis. If the blood tests are consistent with an abnormal parathyroid gland, then further investigations such as a neck ultrasound, sestamibi scan and CT-scan are required to help locate an abnormal gland. This determines the surgical approach required to fix the problem.

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Surgery

All types of parathyroid surgery require a general anaesthetic and an incision in the neck. Hospital stay is usually just one night. Pain in the neck and a sore throat is common. Most people manage with paracetamol only but occasionally need stronger analgesia.

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Minimally invasive Parathyroidectomy (MIP)

Depending on the location of the abnormal gland, a smaller incision can be used. The operation is generally shorter in duration and more targeted, hopefully limiting the risk of bleeding and damage to other structures.

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Neck Exploration

This can be performed on one side (unilateral) or bilateral (both sides). A neck exploration is required when the imaging tests have not confidently localised one abnormal parathyroid gland. It is also indicated with repeat parathyroid surgery. These operations tend to be longer and have a slightly higher risk, but hospital stay is generally the same duration of one to two nights.

 
Risks of surgery

​The complications are similar to thyroid surgery.  Some other more specific complications include low calcium (hypocalcaemia) and further surgery.

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