Hyperparathyroidism and Parathyroidectomy Surgery

The parathyroid glands are small glands that lie next to the thyroid gland in the lower part of the neck.  There are four parathyroid glands, two on each side, each one is as small as a single grain of rice. They produce parathyroid hormone (PTH) which helps control the level of calcium in the blood.

The human body contains a total of 1 kg of calcium. 99% of this is stored in our bones while the remaining 1% can be found in our blood. Parathyroid hormone (PTH) controls the level of calcium in our blood by: 

  1. Controlling the flow of calcium between the bones and the blood. 
  2. Increasing the absorption of calcium from our intestines. 
  3. Increasing the resorption of calcium from our kidneys. 

What is Hyperparathyroidism?

Hyperparathyroidism occurs when the parathyroid glands produce too much PTH. Patients with hyperparathyroidism commonly feel tired, lack energy, and have various aches and pains. However, some patients feel no symptoms. Over time the high parathyroid hormone level leaches calcium out of the bones resulting in osteoporosis and making the bones susceptible to fractures. Patients may experience one or more of the following: kidney stones, constipation, stomach ulcers, pancreatitis and/or depression. 

There are two main types of hyperparathyroidism. Primary hyperparathyroidism  occurs when one or more parathyroid glands are enlarged and makes too much parathyroid hormone. Secondary hyperparathyroidism occurs in response to calcium deficiency, vitamin D deficiency or chronic kidney failure.      

What is Hyperparathyroidism?

Hyperparathyroidism is diagnosed with a simple blood test which will show both a high parathyroid hormone level and a high calcium level.  Once the blood test results are reviewed, Dr. Hall will advise you on what to do next.

Patients with primary hyperparathyroidism usually are recommended to have two scans-an ultrasound scan and a Sestamibi scan. These scans help locate the abnormal parathyroid gland making too much parathyroid hormone.    

Most patients with primary hyperparathyroidism should be considered for surgery.  Patients with secondary hyperparathyroidism due to a vitamin D deficiency require vitamin D supplements.    

Parathyroidectomy 

Parathyroidectomy is the name given to the operation where one or more parathyroid glands are removed. Often two scans (ultrasound and Sestamibi scan) are requested to locate the abnormal parathyroid gland making too much parathyroid hormone.   

Parathyroidectomy is done under general anaesthesia (you are fast asleep). You will most likely spend one night in hospital and are advised to take one week off work to recover. A small incision is made in a skin crease in the lower part of the neck.

The procedure has a high successful rate of 98% and patients usually feel a lot better after their surgery. Complications are uncommon and include failure to fix the problem (1-2%) and a hoarse voice from injury to the recurrent laryngeal nerve (1%). Dr. Hall will advise you the best course of action if this is the case. Other potential, although rare, post parathyroidectomy symptoms include a lower calcium level and injury to the recurrent laryngeal nerve resulting in hoarseness of the voice.  

Dr. Hall and Parathyroidectomy

Dr. Hall has extensive experience with parathyroidectomy, treating both primary hyperparathyroidism and secondary hyperparathyroidism. He always takes the utmost care when conducting surgery and ensures all his patients fully understand their treatment plan. He has also presented his results on parathyroidectomy at the New Zealand Society of Otolaryngology Head and Neck Surgery annual scientific meeting in Queenstown in 2007.  

If you are experiencing hyperparathyroidism symptoms, have been diagnosed with hyperparathyroidism or have been advised to see a parathyroid specialist, Dr. Francis Hall would  be happy to assist you. Please contact us on (09) 281 2963 or book an appointment online.