Niagara ENT & Facial Surgeon
Dr. Babak Karamy, MD, FRCSC
Parathyroidectomy
Welcome to our patient information page about parathyroidectomy surgery. You can learn more about what to expect when you are scheduled for an parathyroidectomy. Find pre- and post-operative instructions here.
Have any questions about your upcoming parathyroidectomy procedure with Dr. Karamy?
Patient Information for Parathyroidectomy
What is Parathyroidectomy?
Parathyroidectomy is a surgical procedure performed to remove one or more of the parathyroid glands, located in the neck.
These glands play a crucial role in regulating calcium levels in the body by producing parathyroid hormone (PTH). When the glands become overactive or develop tumors, it can lead to a condition known as hyperparathyroidism, characterized by excessive PTH production and abnormal calcium levels in the blood. So, parathyroidectomy may be required to treat these conditions.
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Indications for Parathyroidectomy:
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Parathyroidectomy may be recommended for the following conditions:
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Primary Hyperparathyroidism: When one or more of the parathyroid glands develop a non-cancerous tumor (parathyroid adenoma) or become enlarged (hyperplasia), leading to excessive PTH production and abnormal calcium levels.
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Secondary or Tertiary Hyperparathyroidism: In cases where hyperparathyroidism is secondary to chronic kidney disease or another underlying condition, parathyroidectomy may be considered if medical management is unsuccessful.
What Happens During Parathyroidectomy Surgery?
Parathyroidectomy is usually performed under general anesthesia, meaning you will be asleep during the procedure.
The surgeon will make a small incision in the neck to access and remove the affected parathyroid gland(s). In some cases, minimally invasive techniques or focused exploration using imaging studies may be used to locate and remove the gland.
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The surgery typically takes about one to two hours to complete, depending on the specific approach and the number of glands involved.
What Are the Risks of Parathyroidectomy Surgery?
While parathyroidectomy surgery is relatively safe with minimal complications, there are still some risks worth noting.
Some possible risks associated with parathyroidectomy surgery include:
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Bleeding: Bleeding from the surgical site is a possible complication, although it is relatively uncommon. In some cases, a hematoma (collection of blood) may form at the surgical site, which may require drainage.
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Infection: Surgical site infections can occur after parathyroidectomy. Most infections are minor and can be treated with antibiotics, but more severe infections may require additional medical intervention.
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Voice Changes: The parathyroid glands are located close to the vocal cords, and damage to the nerves that control the vocal cords can lead to voice changes, hoarseness, or difficulty speaking. Fortunately, this complication is relatively rare and often temporary.
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Low Calcium Levels (Hypocalcemia): After the removal of an overactive parathyroid gland, the remaining glands may take some time to adjust their hormone production. In some cases, this can lead to a temporary drop in calcium levels, causing symptoms such as tingling or numbness in the fingers, toes, or around the mouth. This condition is usually managed with calcium and vitamin D supplements.
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Permanent Hypoparathyroidism: In rare cases, the parathyroid glands may be accidentally damaged or removed during surgery, leading to a long-term or permanent decrease in parathyroid hormone production (hypoparathyroidism). This condition requires ongoing management with calcium and vitamin D supplements.
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Recurrence of Hyperparathyroidism: While parathyroidectomy is effective in most cases, there is a slight chance that the hyperparathyroidism may return if a new adenoma develops or if all the abnormal glands were not successfully removed during the initial surgery.
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Scarring: Like any surgery, parathyroidectomy leaves a scar at the surgical site. The size and visibility of the scar may vary depending on the surgical approach used.
Pre-Operative Instructions for Parathyroidectomy
Before a parathyroidectomy, you will receive specific instructions from your healthcare provider, including:
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Medications: Inform your healthcare provider about any medications you are currently taking, including over-the-counter supplements. Certain medications, such as blood thinners, may need to be adjusted or temporarily stopped before the surgery.
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Fasting: You will likely be instructed not to eat or drink anything for a specified period before the surgery, usually starting at midnight the night before the procedure.
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Medical History: Inform your healthcare provider about any medical conditions or allergies you have.
Post-Operative Care & Instructions
After parathyroidectomy, you will need to follow specific post-operative care instructions:
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Recovery Period: Plan for a few hours of observation after the surgery before being discharged. Most patients can resume normal activities within a week, but full recovery may take a few weeks.
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Pain Management: We will prescribe you pain medications to manage any discomfort after the surgery.
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Incision Care: Keep the surgical incision clean. Apply an ointment to the incision twice daily for at least 2 weeks. Ointments include aquaphor or polysporin (some people have a reaction to polysporin).
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Activity Restrictions: Avoid strenuous physical activities and heavy lifting for a few weeks after the surgery.
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Follow-Up: Attend all scheduled follow-up appointments to monitor your calcium levels and overall recovery.
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Potential Complications and When to Seek Medical Attention:
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While parathyroidectomy is generally safe, complications can occur. You may need to go to the emergency room if you develop:
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Excessive bleeding or drainage from the incision
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Rapid swelling of your neck
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Fever or signs of infection
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Numbness or tingling around your mouth and hands
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Difficulty breathing or swallowing
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If you are experiencing concerning symptoms or have any questions after a procedure with Dr. Karamy, please contact us​. For emergencies, please go to urgent care.
Disclaimer
The information provided on this webpage is for educational purposes only and should not replace medical advice. Please consult with a healthcare professional for a proper diagnosis and individualized treatment recommendations.