Your parathyroid glands are located in the neck, typically behind the thyroid gland. Most people have four parathyroid glands, each roughly the size of a pea. These glands produce parathyroid hormone (PTH), which helps your body create, store and maintain normal levels of calcium in the body.
Parathyroid disease is associated with over-reactive parathyroid glands. While some parathyroid diseases may only need a ‘watch-and-wait’ approach, others require surgical intervention.
Most frequently, surgery is recommended for hyperparathyroidism. This is when your body produces too much PTH and causes the calcium levels in your body to rise. When you have too much calcium in your blood, it can cause other issues such as weak or painful bones, kidney stones, overreactive bladder, fatigue or memory problems.
Hyperparathyroidism can be caused:
- By an overreactive gland producing too much PTH (primary hyperparathyroidism)
- Another condition, such as kidney failure, renal failure or vitamin D deficiency, that causes the glands to produce too much PTH (secondary hyperparathyroidism)
- By the parathyroid function not returning to normal after being treated for secondary hyperparathyroidism (tertiary hyperparathyroidism)
The type of surgery that your surgeon recommends will depend upon multiple factors, including how severe your hyperparathyroidism is, its root cause, and your individual needs and preferences. Additionally, your surgeon will likely ask that you undergo imaging or other medical tests prior to determine if surgery is appropriate.
The most common types of parathyroid surgeries include:
- Targeted parathyroidectomy: Also known as minimally invasive parathyroidectomy (MIP), your surgeon will likely perform this procedure if a CT scan or other imaging test identified the over-reactive gland ahead of time. With this type of surgery, the incision is typically very small and recovery time is often shorter than other types of procedures.
- Four gland parathyroid exploration: During this surgery, your surgeon will make an incision in the lower neck and examine your glands. Any glands that appear to be abnormal or enlarged are removed. In 96% of cases, there is only one enlarged parathyroid gland,1 which means no other glands need to be removed.
- Partial parathyroidectomy: During this surgery, if multiple glands are enlarged, your surgeon may remove up to 3 or 3½ of the glands. This is so part of the parathyroid tissue remains.
- Total parathyroidectomy: In this procedure, all four of the glands are removed. In some cases, tissue from the parathyroid that is not impacted may be placed in your arm to allow for continued development of PTH.
At our center, you have a team dedicated to developing a personalized treatment plan, taking into account you needs, medical history, cancer type and goals of treatment.
Your parathyroid surgery team will include:
- Your otolaryngologist (head and neck surgeon): Your surgeon specializes in the surgical management of benign (non-cancerous) and cancerous tumors of the head and neck, as well as reconstructive surgery. He/she will perform your parathyroid surgery.
- Your anesthesia team and certified nurse anesthetists (CRNAs): These individuals evaluate, administer and monitor your anesthesia throughout your procedure. Ask your anesthesia team about pain management options for both during and after surgery.
- Your operative room care team: This team is led by your surgeon and comprised of your circulating nurses, your scrub technicians and other team members, all committed to providing your care while you are undergoing your operation.
- Your supportive care team member(s): You may also meet with additional healthcare professionals, such as nurse practitioners, physician assistances, dietitians, occupational therapists and/or speech therapists who can help you manage side effects and better understand your treatment plan.
Soft diet: Also known as a “bland diet,” this includes foods that are soft, mildly seasoned and low in fiber to aid with digestion. This could include beverages included in the clear liquid diet, bread or crackers (avoiding anything that is hard or has seeds/nuts), cooked or dry cereals, cooked noodles, soft fruits (bananas, baked and peeled apples or applesauce, canned fruits, etc.), chicken or fish that is tender, baked beans, tofu, peanut butter, soups, peeled and cooked vegetables, scrambled eggs, soft cheeses or yogurt, as examples.
Your clinical team will advise on when you can return to work and resume normal activities. All of this will depend upon the extensiveness of your surgery and your health status.
While some discomfort, bruising and swelling around the incision site after surgery is normal, call your surgeon if you have:
- A fever over 101°F
- Excessive bleeding that is soaking through the bandage
- If you have any changes in your voice, neck swelling or breathing issues
- Pain that is not relieved with your prescribed medication
- Any new symptom you are concerned about or questions for your doctor
Typically, your surgeon will want to meet with you within one to two weeks after surgery to make sure you are healing well, discuss any new post-operative instructions.
Your care team is always available for you and can help manage any side effects you may experience, even after your surgical treatment is completed.
Contact us
Should you want more information about our treatment services, please visit us online at genesiscare.com/us.
References:
- Norman J. HealthCentral. Parathyroid Surgery: The Standard Technique 2009. https://www.healthcentral.com/condition/hyperparathyroidism/parathyroid-surgery-standard-technique
Fort Myers Surgical Oncology
4571 Colonial Blvd., Suite 210
Fort Myers, FL 33966
Call: (239) 333-0772
Our provider
Scott Larson, MD, Otolaryngologist at Head & Neck Surgical Cancer Specialists of SW Florida, has undergone extensive training to offer TORS and recently performed the first TORS procedure in Southwest Florida.
