Parathyroid Surgery: Everything You Need to Know

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Parathyroid surgery, clinically referred to as “parathyroidectomy,” is a procedure that’s most often used to treat primary hyperparathyroidism (pHPT) in which the parathyroid gland produces too much parathyroid hormone (PTH).

The human body has four small, butterfly-shaped parathyroid glands, located in the neck. They regulate calcium levels in the blood. When one or more of these are too active or are affected by parathyroid cancer (PC), these levels are elevated, a condition called hypercalcemia.

Doctor in white lab coat points on parathyroid glands in anatomic model of thyroid gland. Concept photo for training in anatomy and biology or visualization of parathyroid abnormality or pathology - stock photo

Shidlovski/Getty Images

Most often affecting post-menopausal women, though people of all ages and genders can get it, pHPT can lead to a range of symptoms, including rapid weight loss, irregular heartbeat, and tremors, among others.

Nowadays, parathyroid surgery is primarily conducted as a minimally-invasive, targeted procedure, rather than an open surgery. With the goal of removing the problematic gland or glands, it has a 95% success rate in resolving hyperparathyroidism and is a treatment option for some cases of parathyroid cancer.

If this surgery has been indicated for your condition, understanding how it works as well as what preparation and recovery look like is absolutely critical. The more you know about parathyroid surgery, the better off you’ll be.      

What Is Parathyroid Surgery?

Parathyroid surgery is typically a scheduled surgery, indicated once pHPT or other parathyroid issue is diagnosed. It’s performed either as a more open procedure called bilateral exploration, or as a minimally-invasive parathyroid surgery (MIP) known as directed parathyroidectomy.

The aim is to remove the affected, swollen, and inflamed gland or glands. Since 85% to 90% of patients have only one such gland MIP has become the most common approach.

Performed either while you’re under general anesthesia and put to sleep or using localized anesthetic, MIP relies on smaller incisions, and specialized tools to reduce the impact of this surgery. Surgeons may also employ endoscopic, image-guided, or robot-assisted techniques to perform this work.

These less-invasive techniques have significantly reduced rehabilitation time and lowered the chance of complications. Depending on the scope of the procedure, you may be able to go home the same day, though some patients require a night in the hospital.  

Contraindications

As with any surgery, there may be come patients who aren’t good candidates for the procedure. Factors that may contraindicate minimally-invasive parathyroid surgery include:

  • Some cases of parathyroid cancer may be better treated with other surgeries or treatments, though the more open, bilateral exploration approach can also be considered. MIP typically won’t be used in these cases.  
  • Hereditary hyperparathyroidism, in which the hyperparathyroidism is genetically inherited may also not be resolved with parathyroid surgery.
  • Multiglandular disease, in which multiple parathyroid glands have adenoma or are swollen, is best treated using the traditional bilateral exploration technique.

In addition, some conditions are considered relative contraindications, meaning doctors will have to assess whether surgery is appropriate due to added risk. These include:

  • History of neck surgery
  • Active taking of blood-thinning drugs
  • Chronic kidney disease
  • Previous injury to the recurrent laryngeal nerve
  • Morbid obesity: A body mass index (BMI) greater than 40

Other factors can also play a role in the decision to undergo this surgery, and, ultimately, the doctor needs to decide whether it’s likely to be safe and effective for you.

Potential Risks

Though highly successful, there are some risks of surgery:

  • Recurrent laryngeal nerve injury: If the recurrent laryngeal nerve, which regulates the vocal chords, gets injured during the procedure, temporary or permanent hoarseness can result. The former of these occurs in 5% of cases, and the latter in about 1%.
  • Low blood calcium: In some cases, the removal of the parathyroid gland leads to insufficient calcium levels in the blood. Taking vitamin D and calcium supplements helps correct this issue.
  • Bleeding: Very rarely—in 1 in 300 cases—there’s excessive bleeding due to the procedure, which prolongs the hospital stay.
  • Infection: Infected incisions lead to swelling, heat, and puffiness around the surgical site, as well as high fever.
  • Breathing difficulties: Another rare complication is difficulty breathing after surgery, which resolves over time in nearly all cases.

Purpose of Parathyroid Surgery

Parathyroid surgery is most often employed as a treatment for primary hyperparathyroidism. This condition usually arises due to the growth of benign tumors called adenomas on the glands, causing them to become swollen and enlarged.

While medical management of pHPT is possible, this procedure has been found to be the most effective and cost-effective approach to this condition. However, not every case of pHPT warrants it, and this surgery may also be considered in parathyroid cancer cases.

Specific indications for parathyroid surgery include:

  • Symptomatic hyperparathyroidism: By far the most common reason surgery is employed is in cases where hyperparathyroidism is leading to significant symptoms, such as irregular heartbeat, muscle cramping, dehydration, and others.
  • Age: If hyperparathyroidism is found in anyone under the age of 50—whether symptomatic or not—surgery will be recommended.
  • Asymptomatic hyperparathyroidism with elevated calcium: In asymptomatic cases, surgery will be considered when levels of calcium in the blood are 1 milligram (mg) per deciliter (dL) above the healthy range. Over the long-term, this can be very debilitating.    
  • Hyperparathyroidism and osteoporosis: Patients with osteoporosis (a deterioration of the bones) and/or fractures of the vertebrae associated with this condition, along with hyperparathyroidism, are also good candidates.
  • Hyperparathyroidism and kidney (renal) problems: Surgeons will indicate surgery if the condition is present alongside kidney stones or other disorders.
  • Parathyroid cancer (parathyroid carcinoma): Surgery may also be indicated in some cases of parathyroid cancer, though this would usually only be done using the open, bilateral exploration technique.

Hyperparathyroidism and other conditions of the parathyroid are relatively complicated to diagnose, and this is often a multi-stage process. Several types of tests may be employed:

  • Physical examination and evaluation: The first step in any diagnosis involves a physical and consultation, in which prior medical history, current prescriptions, and benchmarks of health are discussed and evaluated.
  • Blood and hormone tests: Essential to diagnosis will be an evaluation of calcium and vitamin D levels in the blood. In addition, samples will be tested for the presence of other issues, such as kidney problems, as well as the overall level of PTH.
  • Ultrasound: This type of imaging, also known as sonography, relies on the use of very high-frequency soundwaves to create images of the parathyroid and thyroid.
  • Electrocardiogram (ECG): In patients 40 or older, this non-invasive assessment of the heart’s electrical activity will also be employed. This detects arrhythmic heartbeat which can accompany hyperparathyroidism.
  • CT Scan: This uses a combination of X-rays and a computer to create pictures of your organs, bones, and other tissues. It shows more detail than a regular X-ray.
  • Fine needle aspiration: This involves using a thin needle to access the parathyroid gland and remove a small sample. This is then tested for the presence of cancer cells.  
  • Fiber-optic laryngoscopy: This test of vocal cord function is performed using an endoscope, which is a retractable tube with a camera at the end. This allows close, video evaluation of the affected gland or glands.
  • Computerized tomography (CT) scan: Another imaging method frequently used is the CT scan, which uses multiple X-rays from multiple angles to render a 3-D computer model of your parathyroid gland.
  • Sestamibi scan: This nuclear imaging approach uses radioactive elements for highly-detailed imaging of the parathyroid. This involves injecting a safe radioactive material into the bloodstream, that can be picked up using specialized cameras. 

How To Prepare

Perhaps the most important aspect of preparation for parathyroid surgery is patient education. If it’s been indicated for you, you need to have an understanding of how it works, how to prepare, and what else you can do to ensure a good outcome.

You’ll be counseled a great deal in the appointments before your procedure, so pay close attention. Don’t hesitate to ask the endocrine surgeon any questions you have and let them know if there are any changes in your health status.  

Location

Parathyroid surgery takes place in the operating room (OR) of a hospital. What can you expect there in terms of set up? Here’s a quick rundown of what you’ll find:

  • Operating table: You’ll be placed on an adjustable operating table that allows the surgeons to perform the work.
  • Lights: Very bright lighting is crucial for the success of the surgery, so there will be a number of lights set up.
  • Monitors: As this surgery is performed under general anesthesia, you’ll be connected to machines measuring heart activity, level of oxygen in the blood, breathing, and other measures while you’re asleep.
  • Anesthesia apparatus: Throughout the procedure, you’ll be intravenously attached to a machine that delivers exact dosages of the drugs that block pain and/or put you to sleep.
  • Surgical tools: There will be trays set up with surgical tools, such as scalpels, surgical scissors, and others necessary to perform the operation.
  • Respirator and breathing equipment: To ensure you’re getting enough oxygen while on anesthesia, you’ll breathe with the assistance of a respirator.
  • Imaging: In many cases, imaging techniques will be used during surgery to help guide the work. A sestamibi scan may be used to help surgeons identify the exact location of the problematic parathyroid gland.
  • Endoscope: Some approaches to MIP involve the use of this adjustable surgical camera, which transmits real-time video of the affected region to a monitor.
  • Robotic assistance: A more recent innovation in MIP is the use of robotic assistance. Using real-time imaging, the endocrine surgeon controls robotic arms to carefully perform the surgery.  

What To Wear

When it comes to deciding what to wear on surgery day, think comfort and practicality. Doctors recommend emphasizing the following when it comes to wardrobe:

  • Choose loose fits and emphasize comfort. Make sure shirts or bras aren’t too tight.
  • Skip the cosmetics and extras like make-up, nail polish, lotions, or creams.  
  • Don’t wear deodorant, perfume, or any sort of scents.
  • No hairspray, hair clips, or hair ties should be used on surgery day.
  • Leave jewelry at home, including earrings, wedding rings, and watches.

Food and Drink

For the parathyroid surgery, itself, there are no dietary restrictions in the run-up to surgery. However, if general anesthesia will be employed, there are some guidelines for the day before surgery:

  • No food or drink after midnight the night before surgery.
  • Refrain from alcohol for at least 24 hours before your appointment.
  • Sip water with medications, if necessary, but try not to drink anything after midnight.

Medications

To help prepare your body for parathyroid surgery, the medical team may advise you take calcium supplements, aiming for intake of 1,000 to 1,200 mg of this mineral per day.

Generally speaking, there will be few restrictions on what prescribed and over-the-counter drugs as well as herbal or nutritional supplements you can take before parathyroid surgery. However, due to their tendency to increase bleeding, dosages of some may need to be modified, while others might have to be avoided outright. Here’s a quick breakdown:

  • Blood pressure medications: These drugs include Lotensin (benazepril), Prinivil or Zestril (lisinopril), and hydrochlorothiazide (HCTZ), among others. These should not be taken on the day of surgery.
  • Blood thinners: Dosages of blood-thinning drugs also need to be adjusted. These include Coumadin (warfarin), which should be stopped five days before surgery, and heparin, which should be stopped 12 hours before the procedure. Antiplatelet agents, such as Plavix (clopidogrel), among others, may also need to have dosages adjusted.   
  • Aspirin: This common pain-reliever and anti-inflammatory drug, sold under a variety of brand names, such as Ecotrin, also tends to thin the blood. Doctors advise steering clear of this medication for at least seven days before the operation.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): This class of drugs includes Advil or Motrin (ibuprofen), Aleve or Midol (naproxen), and Celebrex (celecoxib), among others. These should be stopped seven days before surgery.
  • Diabetes medications: Oral diabetes medications such as Glucophage (metformin ), glyburide (Glynase), and others, should not be taken the morning of surgery. In addition, insulin dosages may also need to be adjusted.    
  • Other prescribed drugs: Viagra (sildenafil), Premarin, and monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid), Nardil (phenelzine), Emsam (selegiline), and others should be stopped 24 hours before surgery.
  • Herbal supplements: Many herbs, such as St. John’s wort, ephedra, ginkgo supplements, and omega 3 fatty acids, among others, can also cause excess bleeding, as can vitamin E or multivitamins containing it. Intake needs to stop for at least one week before surgery.

Tell Your Doctor What You're Taking

Make sure you’re able to give your doctor a full accounting of all prescribed and over-the-counter medications, as well as any herbs or supplements you’re taking. Only modify dosages as recommended, and don’t try to make any adjustments on your own.

What to Bring

Whether or not you end up staying overnight in the hospital following parathyroid surgery, it will be important to think about what to bring along. Here are some packing list essentials:

  • Insurance information/ID are always good to have along, though make sure you leave valuables with a loved one or at home.
  • A list of medications you’re currently taking, both prescribed and over-the-counter.
  • Allergy information is also important to have; you may want written record of this.
  • Health proxy information legally designates a family member or loved one as an advocate for you with decision making powers, while you’re having surgery and incapacitated.
  • Glasses or contact lenses case may be needed as you may have to take of vision correction prior to surgery.
  • Case for hearing aids may also be necessary, as these sometimes need to be taken out before surgery.
  • Dentures should be worn to the hospitals; however, bring a case along, as you may need to take these out prior to surgery.
  • CPAP/BiPAP machine used to help with breathing should also be brought to the hospital.
  • Robe and slippers may also be helpful for comfort if you need to overnight in the hospital; it may be a good idea to have along even if you expect to go home the same day.
  • Toiletries, such as toothpaste, toothbrush, soaps, and other basics may also prove necessary if you stay overnight.
  • Books/electronics for entertainment may also be good to have along if you expect to recover in the hospital overnight.
  • Your cane, if you use one, should come along on surgery day.  
  • A ride home will be necessary as post-operative patients cannot drive; make arrangements with loved ones or ask the hospital to help arrange transportation.

Pre-Op Lifestyle Changes

Since parathyroid surgery is well-tolerated, not too many pre-operative lifestyle changes are necessary. Doing the following will help reduce the risk of complications:

  • Quit smoking: Smoking tobacco, vaping, or using other nicotine products can severely impact recovery. You should refrain for at least 24 hours before your appointment.
  • Alcohol consumption: You’ll be asked to refrain from consuming alcohol for 24 hours prior to surgery.
  • Losing weight: Patients who are morbidly obese (with a BMI above 40) are at a higher risk of complications. As such, you may be advised to make dietary and lifestyle changes to manage weight in advance of surgery.

What to Expect on the Day of Surgery

A great deal needs to happen immediately before, during, and after parathyroid surgery. The medical team needs to ensure that your body is ready for the procedure, that the operation itself is successful, and that your initial recovery is going smoothly.

All told, the procedure itself takes about one to three hours—depending on the scope of the work—though there’s a significant amount of pre-operative evaluation as well as in-hospital post-operative recovery.

As noted, MIP approaches to this surgery have greatly reduced recovery time, and many patients will be able to go home on the same day of the procedure.  

Before the Surgery

Regardless of whether you’re having MIP or bilateral exploration, a panel of tests will be necessary on surgery day before the work begins in earnest. This initial evaluation, taking place in a pre-operative exam room, includes:

  • Physical evaluation: A final evaluation of medical history and measurement of vital signs, such as heart rate, body temperature, and blood pressure (among others), will be conducted. This will be a final assessment of your readiness to undergo surgery.
  • Blood testing: Absolutely crucial to both preparation for this procedure, and the procedure itself, will be blood tests. This lets doctors get a sense of calcium and vitamin D levels, as well as levels of PTH.
  • Imaging: X-ray, cervical ultrasound, sestamibi scan, or other methods are typically used on the day of the operation as a final means of localizing the problematic parathyroid gland or glands.
  • Consultation with an anesthesiologist: While the consultation with the anesthesiologist to determine the appropriate form and dosage of anesthesia for you often occurs a week or so before surgery, it can also occur on the same day. Before you’re taken to the OR (or shortly after you arrive), you’ll meet with your anesthesiology and be evaluated.  

Once you’re ready, you’ll be taken to the operating room.

During the Surgery

While the more-invasive bilateral exploration approach is highly-effective, MIP techniques have become preferred due to their requiring smaller incisions. While some surgeons augment their approach with ultrasound, endoscopic imaging, or robotic assistance, the aim is always the same: to locate swollen or inflamed parathyroid glands and remove them.

The typical MIP technique goes as follows:

Staging

Once you’re taken to the OR, you’ll be placed on the operating table and given either localized or general anesthesia. You’ll also be given a cervical nerve block injection, which completely blocks pain messaging as the surgery is performed.

Once the surgical team is sure that you’re going to be properly monitored and that you can safely breathe, they’ll mark out areas of incision to plan their work.

Intraoperative PTH (IOPTH) Assay

A standard aspect of parathyroid surgery will be the measurement of PTH levels of the blood, as this will be a sign of success or failure of the surgery.

Taken from blood samples, IOPTH testing is performed just before the procedure begins (as a baseline), at the point in which blood supply for the affected gland is cut off (before the gland is removed), five minutes after the affected gland (or glands) has been removed, and then again at 10 and 20 minutes afterward.   

Incision

Once you’re set, the doctor will carefully make a small, about 2- to 4-inch incision in the middle of your neck; this can be either vertical or horizontal. This allows the surgeons access to the affected area and locate visually the impacted gland or glands.

Tying off Blood Supply

To prevent excess bleeding and other issues, the blood supply to the parathyroid gland needs to be clamped and tied off.

Extraction of the Parathyroid

Once circulation has been stopped, the surgeon will use surgical scissors or scalpel to carefully remove the swollen and inflamed parathyroid gland (or glands). In some cases, surgeons may be able to take out just the adenoma, if one is present.

Finishing Up

Once the affected gland is removed—and IOPTH is showing an adequate reduction in blood calcium levels—your surgeon will be able to close up any incisions and finish the work.

Keep in mind that, in cases where multiple glands are inflamed and swollen—or if cancer is indicated—bilateral exploration may be the only approach. This is similar to MIP, except a larger incision is used, and all four glands are examined (rather than just the problematic one).

And who performs this work? Here’s a quick breakdown of your surgery team:

  • Surgeon: Parathyroid surgery is performed under the direction of an endocrine surgeon, a specialist in treating problems with glands in the body. This kind of doctor has a great deal of training; on top of medical school, they will have done both a residency in surgery, and a fellowship program in endocrine surgery.
  • Anesthesiologist: In charge of ensuring proper amounts of anesthetic medicine are being used in surgery, while keeping an eye on the patient’s response to it, the anesthesiologist is a critical member of the surgery team. This is the doctor you’ll meet with before surgery to discuss your pain managing needs during the procedure.
  • Certified registered nurse anesthetist (CRNA): Assisting the anesthesiologist is the CRNA, a registered nurse trained specifically in anesthesiology. These professionals will primarily be involved with monitoring your health activity, while you’re under general or localized anesthesia.
  • Operating room nurse: Registered nurses specialized in surgery will also be present, providing critical assistance to the endocrine surgeon. These medical professionals have to become certified to work in specific sub-fields of surgery.
  • Surgical tech: Primarily in charge of ensuring proper OR set-up and easy access to necessary surgical tools, surgical techs are certified by the National Board of Surgical Assisting (NBSA). Part of the job involves being able to quickly identify and hand over surgical instruments as needed by the doctor.
  • Residents/medical students: In teaching hospitals, you may also encounter medical students and/or residents, those who have just completed medical school and are working for the first time in the capacity of a doctor.
  • Physicians assistant: This type of professional can practice medicine so long as they are being supervised by a doctor. They may be called in to assist in surgery or take the lead on stitching and/or suturing incisions.

After the Surgery

Following surgery, if you’ve had general anesthesia, you’ll wake up in a recovery room or a special, post-anesthesia recovery unit (PACU). At this point, the main tasks are ensuring that the surgery has gone well and that there are no immediate complications or issues arising.

As mentioned, depending on your status, you may be able to go home the same day of the procedure. What does in-hospital recovery look like for parathyroid surgery? Here’s what happens:

  • Evaluation will be performed to ensure your heart, lungs, and body are recovering well from the procedure and anesthesia. In addition, blood tests or other examinations may be performed measuring calcium and PTH levels to assess overall success of the procedure.
  • You’ll learn about pain management from a member of the medical team. If you’re staying in the hospital for observation, you may receive liquid painkilling medicine. To combat the sore throat that often follows this procedure, you may also be given lozenges or a spray. You’ll also get consultation about any prescribed pain killers, as well as what else you can do to take on discomfort.
  • Education about recovery also occurs before you go home. Here, the medical team will explain what you can do to care for your incisions, what symptoms you should be on the lookout for, as well as other aspects that will prove essential as you get better at home.
  • Overnight stay isn’t always necessary; however, especially those who’ve had more than one parathyroid gland removed may require overnight in-hospital recovery. In these cases, you’ll likely be connected to IVs delivering fluids, be temporarily placed on a liquid diet, and will be monitored closely. The IV is usually taken out the following morning.

Once your doctor is certain that your condition is stable, you can function with minimal assistance, and have made the arrangements necessary for successful recovery, you’ll be free to go.

Recovery

Given the typically minimally-invasive nature of parathyroid surgery, recovery is relatively quick, and significantly easier than it would be for more extensive procedures. All told, complete recovery is expected at one to two weeks.

It will be by week two to four that you’ll need a follow-up appointment. At this appointment, the doctor’s job will be to ensure that there is no infection and that the surgery has successfully resolved the problem.

What does the timeline for recovery look like? Here’s a rundown:

  • Bathing: Avoid showering or bathing for 24 to 48 hours following surgery; this prevents the dressing and bandages on your neck from getting wet. Afterward, wait at least a week before taking a bath.
  • Eating and drinking: Unless you required an overnight stay in the hospital, you should be able to eat and drink as normal as soon as the evening or night of surgery day. Some may want to start with softer, easier to swallow foods.
  • Driving: Do not drive as long as you are taking your prescribed pain medication, as this can impair coordination and response time. Individual cases vary, but three to four days usually elapse before you can get back behind the wheel.
  • Heavy lifting: It’s typically advised that you avoid lifting objects heavier than 10 pounds—as well as more strenuous exercise—for at least one week.  
  • Working: Most patients are expected to take one to two weeks off of work; however, you’re free to go back sooner if you feel up to it. If your work involves heavy lifting or excessive strain, it’s best to wait one to two weeks.

 

Healing

One of the most important aspects of recovery is ensuring that your incision or incisions are healing properly. When you go home, the surgical site will be sutured and dressed in a protective layer of surgical glue. This glue will turn yellow and start peeling at 7 to 10 days, and at this point, it’s OK to pull it off or wait until it flakes off on its own.

As your incisions heal, it’s not uncommon to see bruising around them, and experience some swelling around the region when you stand or sit. Notably, too, the scar may eventually thicken and harden, which can cause temporary difficulty swallowing; this generally resolves at two to three months after surgery.

Critical to a successful outcome will be ensuring that your incision (or incisions) are healing properly and not becoming infected. Here’s a quick overview of what you can do to promote incision care:

  • Watch for bleeding: Excessive bleeding is rare after the first four hours following surgery. That said, seek emergency care if you’re seeing blood in your bandages especially within the first two days after the procedure, especially if it’s coupled with changes in your voice, swelling in the neck, or breathing problems.
  • Hygiene: Most will be advised to hold off on showering for at least 24 hours after surgery. Then, you can take showers so long as you don’t completely soak the incision sites and aren’t rubbing them. After a shower, use a hair dryer set to a cool setting to dry the area. You’re best off waiting until your incisions have completely healed before taking a full bath.  
  • Wear sunscreen: As your incision or incisions are healing, make sure to wear sunblock if you plan on going out in the sun. This will prevent sun damage and help minimize discoloration.
  • Watch for infection: If you’re experiencing high fever, excessive swelling, tingling or burning sensations, or seeing discharges, your incision is likely infected. In these cases, let your doctor know and/or seek emergency care.

Long Term Care

While recovery from parathyroid surgery is relatively quick, preserving the positive outcomes of the procedure should be a lifelong effort. This means being mindful of your health, and, in rare cases, attending to lingering side-effects of this treatment. What should you keep in mind over the long term? Here are a few tips:

Calcium Supplementation

In the 24 to 48 hour window following surgery, patients may experience hypocalcemia, a condition in which calcium levels in the blood are too low, leading to muscle cramps, tingling sensations, and other symptoms. In about 5% of cases, this condition becomes permanent, and you’ll need to take prescribed calcium supplements.

Managing Vitamin D Levels

After surgery, insufficient levels of vitamin D can also lead to hypocalcemia, something which is often taken on in advance of treatment. That said, this pre-operative management can sometimes also cause problems, leading to kidney stones and hypercalcemia.

In some cases, it can be helpful to work with a parathyroid doctor or nutritionist to figure out strategies to ensure healthy levels of this vitamin.

Possible Future Surgeries

If parathyroid surgery doesn’t resolve the pHPT or other conditions, other procedures may be required. In advanced cases, additional procedures may also be needed to make sure that there is at least one functioning parathyroid in the body. What surgeries might follow this one? There are several:

Revision Parathyroid Surgery

In cases where pHPT is recurring or persists despite an initial surgery, another of the remaining parathyroid glands has become swollen and inflamed.

This can occur if surgeons did not recognize that other glands were affected, didn’t sufficiently remove problematic tissue in the original treatment, or there were other unintended complications. Revision surgery targets the remaining, problematic gland or glands.

Autotransplantation

If all parathyroid glands were removed, a person would need to permanently keep a close on calcium levels. As such, if, due to the severity of the case or previous parathyroid surgery, a patient is at risk of losing all of these glands, doctors will transplant some of the tissue to another part of the body.

Typically, the forearm is a preferred location, or on the sternocleidomastoid muscle. After 4 to 6 weeks, the transplanted parathyroid becomes active again.

Cryopreservation

Another procedure common in severe cases of pHPT leading to a risk of losing all parathyroid glands, surgeons may take a small sample of the flesh and store it. If necessary, the surgeon can then thaw out and implant this tissue in the manner of autotransplantation.

A Word From Verywell

Historically, and as practiced today, parathyroid surgery has been remarkably successful in helping people manage the difficulties of pHPT and hypercalcemia. While the thought of undergoing this treatment—or any kind of surgery—may be daunting, the benefits are undeniable.

Beyond the improvements to physical health, studies have shown that up to 70% of post-operative patients experience a significant boost in quality-of-life. Not only that, patients report feeling significant improvements within weeks or even days of this procedure.

As it has been for so many people, parathyroid surgery just may be the key that unlocks the door to healthier and happier days.

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