What is a parathyroidectomy?
The parathyroid glands secrete a hormone that releases calcium from your bones to your bloodstream, increasing the calcium in your body. There are usually four of them located posterior to the thyroid gland. One or more of these glands can be enlarged and secrete abnormally increased amounts of parathormone (PTH).
Overactive parathyroid glands can result in osteoporosis, fractures, high blood pressure, depression, fatigue, renal stones, pancreatitis, and stomach ulcers. Workup for hyperparathyroidism includes an intact PTH level with a serum calcium level, 24 hour urine calcium, sestimibi-parathyroid scan, and ultrasound of the thyroid and parathyroid.
Drs. Alfred Simental and Paul D. Kim specialize in minimally invasive neck explorations, which under the right conditions may be performed as an outpatient with mini incisions under local anesthesia.
Minimally Invasive Parathyroidectomy
Conventional standard parathyroidectomy surgery includes identification of all parathyroid glands on both sides of the neck and subsequent removal of any abnormal glands.Most frequently, a single abnormal gland (adenoma) is responsible; however, 10-15 percent of the multiple glands (hyperplasia) may be responsible and require removal.
A nuclear medicine study known as a parathyroid scan is often able to localize the position of the over-functioning gland, allowing a more focused surgical exploration.At Loma Linda University we routinely use a rapid intraoperative parathyroid hormone assay to ensure the surgical success.A blood level of the hormone is taken at the start of surgery and then 10 to 15 minutes after surgery.A greater than 50 percent drop in hormone level in that time correlates with successful removal of the parathyroid adenoma.
Complications from parathyroid surgery are rare and include vocal cord paralysis, scar, and permanently low calcium. Most patients go home the same day.