Parathyroid Surgery

What are the parathyroid glands?

Most people have four parathyroid glands, 2 on each side in very close relation to the thyroid gland. They are small glands that secrete parathyroid hormone which has an essential role in regulating blood calcium levels.

When do I need parathyroid surgery?

Parathyroid surgery may be recommended by your endocrinologist for excessive production of parathyroid hormone which leads to elevated blood calcium levels. Hyperparathyroidism and hypercalcemia can manifest as a collection of symptoms including:

  • Bone loss leading to osteoporosis and in severe cases pathological fractures

  • Kidney stones

  • Abdominal symptoms such as discomfort and constipation

  • Muscle aches and pains

  • Cognitive effects such as fatigue, weakness, forgetfulness, or depression

What type of parathyroid surgery do I need?

Hyperparathyroidism is commonly due to a benign overgrowth of one of the glands called a parathyroid adenoma. With modern imaging studies (neck ultrasound, 4D CT, sestamibi scans) it is often possible to pre-operatively identify the culprit gland and do targeted surgery. Dr Shaw offers minimally invasive surgery (focused parathyroidectomy) in these cases through a roughly 2-3cm incision.

Sometimes it is not possible to identify a single responsible gland with imaging studies so a traditional exploration of all four glands in surgery is required.

What are the potential complications of parathyroid surgery?

  • Failure to achieve cure of hypercalcemia (1-5% risk)

  • Rebound temporary low blood calcium levels

  • Permanent hypoparathyroidism (only when removing multiple glands)

  • Symptomatic blood clot in the neck ~1%

  • Injury to nerve to vocal cords ~1%

  • Wound infection is also uncommon