What Is Parathyroid Surgery?
The parathyroid glands are four little round glands that sit in the neck surrounding the thyroid gland. These glands are involved in regulating your body’s calcium levels through a hormone called parathyroid hormone (PTH). Parathyroid surgery involves removing one or all four of these glands in special cases in which your body makes too much calcium.
How Do You Prepare For Parathyroid Surgery?
Before having parathyroid surgery, it is important to discuss with your doctor the risks, benefits, and alternatives to proceeding with surgery. Depending on the reason for your parathyroid surgery you may require blood work and laboratory testing, in addition to imaging, in preparation for your surgery.
Why Is Parathyroid Surgery Performed?
Parathyroid surgery is most often performed in cases in which your body makes too much calcium. This is most commonly because of a small benign growth in one of the four glands, called a parathyroid adenoma. Parathyroid surgery involves removing benign growth. Sometimes, if you have a history of kidney problems, all four of your glands may be too active and cause an increase in your calcium levels. In this case, all four of the parathyroid glands are removed, with ½ of one reimplanted back in the body. This will help in also restoring your body’s calcium levels to normal levels. In exceedingly rare circumstances, parathyroid glands may develop a form of thyroid cancer requiring their removal.
What Can You Expect During Parathyroid Surgery?
Parathyroid surgery is a commonly performed surgery in the United States. It is usually performed under general anesthesia in a hospital or an ambulatory care facility. Depending on the type of surgery, you may be able to go home the same day or may require a short hospital stay for observation. The actual surgery involves making a small incision in the front part of your neck below the Adam’s apple. Surgeons try and hide the scar as best they can so that it heals in the most imperceptible way possible. Once the surgery is complete, you are awoken and after a short recovery period, you may go home.
What Is The Followup And Recovery Like For Parathyroid Surgery?
Depending on the type of surgery, you may be able to go home right after the surgery. Sometimes, you may need to stay in the hospital for a short stay for observation before you can be released to go home. It is not uncommon to have some difficulty and soreness with swallowing. This typically resolves after a few days, but sometimes may last up to 2 weeks. It is also not too uncommon to experience some hoarseness that usually resolves after several days. You may experience pain and discomfort in the neck from having the surgery, and pain medicines are usually prescribed to manage this pain.
We usually recommend no heavy lifting or exercising during the healing period, while recommending staying home from work until your first postoperative office visit. This is to maximize your healing and prevent any complications. During this time period, your surgeon will specify how best to manage your neck incision site. Some surgeons recommend no bathing or showering for 24 hours, while other surgeons may apply a waterproof dressing. It is important to clarify the specific instructions with your doctors and nurses. Depending on how you are healing, your surgeon will clear you to resume regular activities.
What Are The Potential Costs For Parathyroid Surgery?
Parathyroid surgery is typically covered by your insurance. Depending on the type of insurance you carry, there may be associated out of pocket expenses. Fortunately, Dr. Mourad’s staff are experts in understanding insurance, and work closely with insurance companies, making sure to maximize your benefits.
What Are The Potential Risks For Parathyroid Surgery?
Fortunately, the risks during parathyroid surgery are low. Depending on the indication and the type of surgery you are having, there are certain risks. The nerves that control the voice box are very close to the parathyroid glands, and removal of the glands may result in inadvertent stretching or injury that causes hoarseness. This hoarseness is typically temporary, but in rare circumstances may be permanent. Other risks include the need for further surgeries. Sometimes, calcium levels stay elevated even after parathyroid surgery, resulting in the need for follow up surgeries. Finally, the body may develop an unexpected drop in calcium following removal of the thyroid gland, called hypocalcemia. This is usually temporary but may require hospitalization to restore the body’s calcium levels.
Is Parathyroid Surgery Outpatient Or Inpatient?
Parathyroid surgery is usually performed in an outpatient setting. However, depending on the indication and the type of surgery you have, and the presence of other medical problems, patients may be required to have a short hospital stay during their recovery period.
Is Parathyroid Surgery Necessary?
Depending on the blood levels of calcium and associated symptoms, it is usually necessary to have parathyroid surgery to help reduce the body’s levels of calcium.
Should I See Dr. Mourad About My Parathyroid Surgery?
Dr. Mourad is an expert in the area of parathyroid surgery and is one of New York City’s highest volume thyroid/parathyroid surgeons. He routinely performs more than 50 thyroid/parathyroid surgeries every year, in addition to having published leading scientific works on parathyroid surgery.
Select Relevant Publications
Moustafa Mourad MD Masoud Saman MD Raja Sawhney MD Yadranko Ducic MD. Management Of The Thyroid Gland During Total Laryngectomy In Patients With Laryngeal Squamous Cell Carcinoma. Laryngoscope. 2015 Aug; 125:1835–1838. Link to Article.
Mourad M, Kadakia S, Jateganokar A, Gordin E, and Ducic Y. Intraoperative Nerve Monitoring During Parathyroid Surgery: The Fort Worth Experience. Head & Neck. 2017 Aug;39(8): 1662-1664. Link to Article.
Kadakia S, Mourad M, Hu S, Brown R, Lee T, and Ducic Y. Utility of intraoperative nerve monitoring in thyroid surgery: 20-year experience with 1418 cases. Oral Maxillofac Surg. 2017 Sep;21(3):335-339. Link to Article.
Kadakia S, Mourad M, Badhey A, Lee T, Gessaroli M, and Ducic Y. The role of intraoperative nerve monitoring in tracheal surgery: 20-year experience with 110 cases. Pediatric Surgery International. 2017 Sep; 33(9): 977-980. Link to Article.