Parathyroid disease is due to abnormal function of one of four parathyroid glands in your neck. These are located on each side of your thyroid gland, although sometimes they can be in abnormal locations when they enlarge.
Hyperparathyroidism is a condition in which one or all four parathyroid glands produce an excess of parathyroid hormone (PTH). This leads to abnormally high levels of calcium in the bloodstream, leading to symptoms of fatigue, kidney stones, osteoporosis, peptic ulcers, and nervous system complaints.
Most patients (95%) with parathyroid disease have one of four glands enlarged known as a parathyroid adenoma. The other 5% have all four glands enlarged (parathyroid hyperplasia). Rarely there may be a so-called double adenoma. For those patients with one gland enlarged, surgery has evolved into Minimally Invasive Parathyroid Surgery. Patients with hyperplasia will usually require the traditional operation exploring both sides of the neck and may require the removal of more than one gland.
Parathyroidectomy (parathyroid gland removal)
A parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone (PTH).
Surgery is performed under general anesthesia. A PTH level is often checked during and after surgery to confirm that the diseased gland has been removed. Patients may be prescribed calcium supplements to take postoperatively as the blood calcium levels can sometimes temporarily drop to levels that are too low once the diseased gland is removed.
Risks of Surgery
Risks of surgery include bleeding, infection, injury to the nerves to the vocal cords, and abnormally low levels of calcium in the blood. Followup with an endocrinologist is usually recommended.