Parathyroid Surgery

Symptoms of a parathyroid condition

Symptoms of a parathyroid condition may include:

  • Fatigue and mood changes
  • Problems with memory and concentration
  • Thirst and subsequent increased urination (especially overnight)
  • Kidney stones
  • Constipation
  • Reduced bone density, which can increase the risk of fractures
  • Muscle cramps and spasms
  • Anxiety and/or depression
  • Nausea and vomiting

Parathyroid conditions

Primary hyperparathyroidism

Primary hyperthyroidism is a condition which results in the enlargement of one or more parathyroid glands. It causes unregulated parathyroid hormone production which can elevate the blood calcium levels. It is most commonly caused by noncancerous growths (adenomas) on the parathyroid glands.

Primary hyperparathyroidism can only be cured with surgery, although surgery is not always needed. If the symptoms aren’t too severe, ongoing observation and monitoring may be recommended instead.

Secondary hyperparathyroidism

Secondary hyperparathyroidism occurs when the parathyroid glands release too much parathyroid hormone due to low blood calcium levels. This usually comes as the result of an underlying condition (such as chronic kidney disease) and can cause calcium to build up in the body’s tissues and organs.

Secondary hyperparathyroidism may be treated with vitamin D supplements, which help the body absorb calcium. It may also be treated with medications such as Cinacalcet, which act directly on the parathyroid glands to lower the blood parathyroid hormone level. If medication is ineffective in managing secondary hyperparathyroidism, surgery may be recommended to remove the glands.

After your doctor diagnoses a parathyroid condition, they may organise more tests to determine any secondary causes or potential underlying conditions. These tests may include:

  • Urine testing – this can determine how well your kidneys are functioning and measure the amount of calcium excreted.
  • An ultrasound scan of the neck
  • A special nuclear medicine scan called a sestamibi scan
  • A CT scan of the neck (4D-CT)
  • Imaging of the kidneys – an ultrasound, X-ray, or other imaging tests may be used to look for kidney stones or other abnormalities.
  • Bone mineral density testing (DEXA) – this assesses the impact the parathyroid condition has had on your bones and may diagnose osteoporosis.

Depending on the results of your testing and your diagnosis, your doctor will recommend a course of action to best manage your condition. This may include a watch-and-wait approach, management through medication, or parathyroid surgery to remove one or more parathyroid glands.

Your surgeon will review your imaging results when planning a course of action and may request additional scans and tests. At ORBE Surgeons, we take care to fully assess every facet of your condition and determine an individualised approach best suited to your needs.

Depending on the nature of the procedure and the location of the glands to be removed, your ORBE surgeon may be able to provide a minimally-invasive parathyroid procedure. This results in a much smaller scar and often a shorter recovery time than a traditional open parathyroid surgery.

As the glands can often be found in unusual (ectopic) locations, parathyroid surgery is best performed by experienced surgeons such as those at ORBE Surgeons.

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