Parathyroidectomy—Conventional
(Parathyroidectomy—Open; Parathyroidectomy—Standard; Parathyroid Gland Removal—Conventional; Parathyroid Gland Removal—Open; Parathyroid Gland Removal—Standard)
Pronounced: peh-rah-THIGH-roy-dek-tah-me
Definition
A parathyroidectomy is a surgery to remove parathyroid glands. There are 4 parathyroid glands located in the neck. The glands make a hormone that balances the level of calcium in the blood.
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Reasons for Procedure
The surgery is done to remove one or more abnormal parathyroid glands. The glands may be overactive, or abnormal due to cancer or for other reasons.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Bleeding
- Hoarseness
- Low calcium levels in the blood—more common if all 4 glands are removed
- Wound infection
- Reaction to the anesthesia
- Skin tethering—tissues and skin may become attached to the voice box or windpipe
- Scarring
- Blocked airway
- Damage to nerves, which can cause problems like paralyzed vocal cords
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
Prior to Procedure
Your doctor will:
- Do a physical exam and ask you about your medical history
- Order imaging test such as ultrasound or parathyroid scan
- Have blood tests done
You should:
- Arrange to have someone drive you home from the hospital after surgery.
- Avoid eating or drinking 6-8 hours before surgery.
- Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to 1 week before the procedure.
Anesthesia
General anesthesia is used most often. It will block any pain and you will stay asleep through the surgery. The area will be numb but you will be awake.
Description of the Procedure
An incision will be made in the neck. Muscle and other tissue will be moved to locate all the glands. The abnormal gland or glands will then be cut out and removed. A drain may then be placed in the area. This will allow fluids to drain out of the area while you heal. The incision will be closed with stitches.
If all 4 glands were removed, a part of one gland may be placed in a different area of the neck or in the forearm.
How Long Will It Take?
20 minutes to several hours, depending on how many glands need to be removed
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
You may need to stay in the hospital for 1-2 days. Your doctor may choose to keep you longer if you have any problems.
Post-procedure Care
At the Hospital
After your surgery, the the hospital staff will:
- Observe you in the recovery room.
- Check on your ability to swallow and speak.
- Test your calcium levels.
- Show you how to change your dressings and care for your wound.
- Remove the drain if one was placed during surgery.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
At Home
To help your recovery at home:
- You may be given calcium supplements.
- Follow your doctor's instructions.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
- Tingling or numbness in the fingertips, toes, hands, or around the mouth
- Twitching or cramping of muscles
- Redness, warmth, drainage, or swelling around the area where surgery was done
- Difficulty swallowing, talking, or breathing
- Signs of infection, including fever and chills
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org
Endocrine Diseases—The American Association of Endocrine Surgeons
http://endocrinediseases.org
CANADIAN RESOURCES:
Canadian Cancer Society
http://www.cancer.ca
Canadian Society of Otolaryngology
http://www.entcanada.org
REFERENCES:
Farndon JR. Surgical treatment: Evidence-based and problem-oriented. Postoperative complications of parathyroidectomy. Available at: http://www.ncbi.nlm.nih.gov/books/NBK6967. Accessed December 28, 2018.
Parathyroid surgery. The American Association of Endocrine Surgeons website. Available at:http://endocrinediseases.org/parathyroid/surgery_overview.shtml. Accessed December 28, 2018.
Parathyroidectomy. Cedars-Sinai website. Available at: http://cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Parathyroidectomy.aspx. Accessed December 28, 2018.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed June 2018 by Michael Woods, MD Last Updated: 12/28/2018