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Parathyroid Surgery

What are the parathyroids?

The parathyroids are four tiny glands in your neck, two on each side of your thyroid gland. They make parathyroid hormone (PTH) which controls the level of calcium in the blood. Calcium is very important for the normal functioning of muscles, nerves, and bones. It is absorbed through the intestines and stored in the bones. Parathyroid hormone raises blood levels of calcium by increasing intestinal absorption of calcium, and by dissolving calcium from the bone into the bloodstream.

parathyroid surgery perth

What is hyperparathyroidism?

Some people make too much parathyroid hormone, a condition called hyperparathyroidism. In 90% of patients with hyperparathyroidism, the cause is a single benign tumour. In 10% of patients, more than one parathyroid gland is enlarged. Cancer is rare. The overactive parathyroid steals calcium from your bones and puts it into the bloodstream. High blood calcium can cause you to feel tired and irritable, and have aches and pains. Over time, your bones can become weak, and your risk of bone fractures is higher.

Treatment of hyperparathyroidism

The only effective treatment for hyperparathyroidism is surgery to remove the overactive gland(s). In the hands of an experienced endocrine surgeon, surgery can cure the condition in 95% of cases. There is no effective non-surgical treatment for hyperparathyroidism. Before surgery, you may have a sestamibi localisation study (a painless scan) and a neck ultrasound to see if there is one enlarged gland that can be located. If the abnormal gland is seen, you can have “parathyroid mini-surgery” though a very small incision.

If the gland is not seen on scanning, the operation is slightly longer, but is still successful in 95% of cases. The surgery takes about 1-2 hours, and the incision is low on your neck. You will be completely asleep during the operation. Recovery is quick, with most patients going home the next day, and feeling very little discomfort. Most are back at work in a about a week.

What are the possible complications of parathyroid surgery?

The nerves that control your voice are closely associated with the parathyroid glands. In 1% of parathyroid operations, the nerve that controls the voice is permanently affected, leaving your voice hoarse.

Sometimes the surgery will not cure the hyperparathyroidism. In the hands of an experienced endocrine surgeon, failure to cure occurs in roughly 5% of patients. The most common reason is another enlarged parathyroid that was not seen on initial imaging. These can be found at a second operation, required in about 4-5% of patients.

There is a small risk of bleeding into the wound. If this happens, it may be necessary to have a second operation to evacuate the blood so it does not interfere with your breathing. Infection is relatively uncommon, and is easy to treat should it occur.

Parathyroid Surgery Perth – Advance Surgical

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