What is Parathyroid surgery?
Parathyroidectomy is the surgical removal of one or more parathyroid glands. The parathyroid glands are four pea-sized glands located on back of the thyroid gland in the neck. The parathyroid glands make parathyroid hormone (PTH), which controls the levels of calcium in the body.
In patients with hyperparathyroidism, one or more parathyroid glands become enlarged and overproduce parathyroid hormone, causing levels of calcium to rise in the blood. Surgery to remove the enlarged gland (or glands) is the only definitive treatment for the disorder and cures it in 95 percent of cases.
What are the risks in Surgery?
There are three main factors that contribute to risk in Parathyroidectomy.
- Recurrent Laryngeal Nerve Damage/Injury: Vocal cords are controlled by this nerve and if any damage or injury caused to this nerve, you will have a Hoarse voice. Percentage of suffering from Permanent Hoarseness is 1% and 5% chance is for Temporary Hoarseness (<6Months).
- Low Calcium in Blood: Blood Calcium levels are controlled through parathyroid glands that lie behind your thyroid gland. During surgery, if they are injured or removed then it can affect the blood calcium and it can be too low. Eventually, this would increase the intake of calcium and Vitamin D supplementation. Possibility of Permanent Calcium supplementation is 1% and a 5% chance of Temporary Calcium supplementation.
- Bleeding: Risk of bleeding during surgery is 1/300 and this is the main reason for a patient to stay at least overnight or for 24 hours in the hospital.
How do you prepare for yourself for surgery?
It is not mandatory to change the diet and/or most medications prior to your surgery. As part of the pre-operative assessment, we may obtain a set of labs, chest Xray and EKG. If you take blood thinning medications, such as aspirin, Plavix, or Coumadin, we will contact your physician to discuss stopping these medications prior to your surgery.
How long do I have to stay in the hospital? Can I have or ask someone to stay with me overnight?
Most patients only spend a night or maximum 24hrs in the hospital or discharged at the end of the surgery day, depending on the patient condition. We have private rooms, so a relative is certainly able to stay with you.
Will there be a scar after the Surgery?
The length of the incision is about 2-3inches and it is placed in the middle of the neck on a normal skin crease to reduce the scarring and visibility.
How do I care for the Surgical Incision?
Steristrips will be placed on your incision which can be removed after 10-14days from your operation. It is not mandatory or require to place additional or further dressing on your incision. You can apply Vitamin E oil or similar product rich in Vitamin E to fasten the healing process, but it is not necessary to use. The patient can take a shower.
What type of medicines will be prescribed after the operation?
Your blood calcium will be checked after the operation and in the morning following your operation. If your blood calcium level is low following your operation, you may experience hypocalcemia symptoms such as numbness/tingling and muscle cramping. These symptoms are relieved by taking calcium supplements and, if needed, vitamin D. You can take 2 grams of calcium (4 tablets of 500mg Tums) every 4 hours as needed for your symptoms. Pain medication may be taken as necessary and is usually only needed for three to four days following parathyroidectomy.
When can I expect to return to work?
In general, you can return to work usually within one to two days.