Why is Parathyroidectomy Performed?

Why is Parathyroidectomy Performed?
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The Parathyroid Glands

Most people have four parathyroid glands, although more or less than four may be present in some individuals. The glands are located on either side of the trachea in the neck, near the thyroid gland. In some cases the glands may be in slightly different locations. For example, they may be in the thyroid gland itself, or in the chest. The parathyroid glands are small, each around the size and shape of a pea.

These glands produce a hormone called parathyroid hormone. The main function of the hormone is to regulate the body’s blood and bone calcium levels.

Despite the name of the glands, they have nothing to do with the function of the thyroid gland itself. The name is based solely on the fact that the parathyroid glands are located next to the thyroid.

Parathyroid Gland Malfunction

Malfunction of the parathyroid glands can lead to calcium deficiency in the bones. One of the ways in which the hormone works is to cause the bones to release calcium in the bloodstream. If the glands produce too much parathyroid hormone, this can lead to depletion of calcium from the bones, and eventually to osteoporosis. If the glands produce too little hormone, the result may be dangerously low blood calcium levels, which can lead to muscle cramps, spasms, and seizures.

When the parathyroid glands malfunction and produce too much hormone—usually due to either diseases such as cancer—surgery is often the only permanent cure.

The Parathyroidectomy Procedure

During a parathyroidectomy procedure the patient is usually under general anesthetic. Local anesthesia may be indicated in cases where general anesthesia is a health risk. In such cases, the patient may receive a local anesthetic combined with medication to aid relaxation.

The procedure begins with an incision of around four to six inches in the neck, slightly beneath the location of the Adam’s apple. Next, the surgeon locates the parathyroid glands and removes any of the glands which show signs of disease. In some cases this may mean removal of all four glands, in other cases removal of just one or two.

Before closing the incision and finishing the procedure, the surgeon may order a blood test to ensure that all the diseased parathyroid glands have been removed. This test checks for levels of parathyroid hormone and is completely quickly to minimize the time the patient spends under anesthetic.

Parathyroidectomy has certain associated risks. These include thyroid gland injury, low levels of parathyroid hormone, and injury to the vocal cords. Very rarely, people who undergo a parathyroid gland removal procedure may experience difficulty breathing for a few months afterwards.

References

James K. Bredenkamp, MD, FACS. Parathyroidectomy

National Institute of Health MedlinePlus: Parathyroid Gland Removal

Michael E. Debakey Department of Surgery at Baylor College of Medicine: Parathyroidectomy