Parathyroidectomy
Encyclopedia
Also known as "Parathyroid gland removal", Parathyroidectomy is the surgical
removal of one or more parathyroid gland
s. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone
. As drugs such as Fosamax do not treat the underlying cause of parathyroid-related osteoporosis
, surgery is the only cure. Bone loss is reversible.
The location of the glands is generally behind the thyroid
, but there is a lot of variation. Usually, the location of an enlarged gland has been confirmed via a sestamibi scan or on ultrasound
.
, the patient is usually put under a general anesthetic (unconscious and pain free) or a local anesthetic
(pain free). The surgeon
makes an incision around an inch long in the neck just under the Adam's apple
and locates the offending parathyroid glands. Preoperative testing using sestamibi
scanning can identify the location of glands. It can also be used to limit the extent of surgical exploration and facilitate a radioguided parathyroidectomy.
The particular problem or disease will determine how many of the parathyroid glands are removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism
.
The patient
usually recovers very quickly after the operation. The PTH
level is back to normal within 10–15 minutes, and is confirmed by routine blood tests following the operation. However, the remaining parathyroid glands may take hours to several weeks to return to their normal functioning levels. Patients must be placed on calcium supplements to prevent symptoms of hypocalcemia and to restore lost bone mass.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
removal of one or more parathyroid gland
Parathyroid gland
The parathyroid glands are small endocrine glands in the neck that produce parathyroid hormone. Humans usually have four parathyroid glands, which are usually located on the rear surface of the thyroid gland, or, in rare cases, within the thyroid gland itself or in the chest...
s. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone
Parathyroid hormone
Parathyroid hormone , parathormone or parathyrin, is secreted by the chief cells of the parathyroid glands as a polypeptide containing 84 amino acids...
. As drugs such as Fosamax do not treat the underlying cause of parathyroid-related osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, surgery is the only cure. Bone loss is reversible.
The location of the glands is generally behind the thyroid
Thyroid
The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage...
, but there is a lot of variation. Usually, the location of an enlarged gland has been confirmed via a sestamibi scan or on ultrasound
Medical ultrasonography
Diagnostic sonography is an ultrasound-based diagnostic imaging technique used for visualizing subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions...
.
Procedure
During the operationSurgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, the patient is usually put under a general anesthetic (unconscious and pain free) or a local anesthetic
Local anesthetic
A local anesthetic is a drug that causes reversible local anesthesia, generally for the aim of having local analgesic effect, that is, inducing absence of pain sensation, although other local senses are often affected as well...
(pain free). The surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
makes an incision around an inch long in the neck just under the Adam's apple
Adam's apple
The laryngeal prominence—commonly known as the Adam's Apple—is a feature of the human neck. This lump, or protrusion, is formed by the angle of the thyroid cartilage surrounding the larynx...
and locates the offending parathyroid glands. Preoperative testing using sestamibi
Sestamibi
Technetium sestamibi is a pharmaceutical agent used in nuclear medicine imaging. The drug is a coordination complex of the radioisotope technetium-99m with the ligand methoxyisobutylisonitrile . The generic drug became available late September 2008...
scanning can identify the location of glands. It can also be used to limit the extent of surgical exploration and facilitate a radioguided parathyroidectomy.
The particular problem or disease will determine how many of the parathyroid glands are removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism
Hypoparathyroidism
Hypoparathyroidism is decreased function of the parathyroid glands with under production of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany , and several other symptoms...
.
The patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
usually recovers very quickly after the operation. The PTH
PTH
PTH may refer to:*Parathyroid hormone*Pin through hole, mounting scheme used in electronics with component leads inserted through drilled holes*Plated through hole, used in electronics to connect layers with plated through hole vias...
level is back to normal within 10–15 minutes, and is confirmed by routine blood tests following the operation. However, the remaining parathyroid glands may take hours to several weeks to return to their normal functioning levels. Patients must be placed on calcium supplements to prevent symptoms of hypocalcemia and to restore lost bone mass.