About the Parathyroid Glands
What Are the Parathyroid Glands?
There are normally 4 parathyroid glands located near or attached to the back surface of the thyroid. Each gland is usually about the size of a grain of rice (about 3-5 millimeters in diameter and around 30 - 60 milligrams in weight). Although the thyroid and parathyroid glands are physically near to each other and are both part of your body's endocrine system, their functions are not related. Parathyroid glands secrete a hormone that controls your blood calcium level. Calcium is important for muscle and nerve function.
When is Parathyroid Surgery Needed?
Parathyroid glands make parathyroid hormone (PTH) to regulate the level of calcium in the blood. Other cells in the body, especially cells of the bones, kidneys, and small intestine, respond to PTH by increasing the calcium levels in the blood. Under normal conditions, this control is quite accurate. If one or more parathyroid glands enlarge and become overactive, your blood calcium level may increase. This condition is called primary hyperparathyroidism. These tumors are nearly always benign, but they may cause other problems such as kidney stones, mood changes or depression, and weakened or painful bones. The most common treatment for primary hyperparathyroidism is surgical removal of the abnormal gland or glands. Surgery can provide a permanent cure for this condition.
How is Parathyroid Surgery Usually Performed?
Parathyroid operations takes place in the operating room. Most operations are done under sedation and local anesthesia, though general anesthesia can be used.
Learn More About Minimally Invasive Parathyroidectomy (Video)
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An incision is made in the anterior neck near the abnormal gland. The surgeon removes one or more of the parathyroids, depending on the specific disorder. The parathyroid hormone level in the blood is measured during the procedure. This should return to normal within 15 minutes of removing the abnormal parathyroid gland. This result is known before the operation is concluded. The muscles are then repaired and the skin incision is closed with sutures that will either absorb or be removed soon after your operation. Often the skin is closed with surgical glue.
Protecting the nerves serving your vocal cords and the remaining parathyroid glands so they will function normally is an important part of your surgery. It is not uncommon to have a low calcium level after a successful surgery. That situation is nearly always temporary and normal function is restored in over 98% of people in just a few weeks.
You may have read about minimally invasive, or "keyhole" surgery for this problem. This is the usual approach at University of Michigan, but requires identification of the abnormal parathyroid gland before operation, usually with ultrasound scan or sestamibi scan. Most patients go home within 2 hours after the operation.