Parathyroidectomy (Parathyroid Surgery)

What is parathyroidectomy (parathyroid surgery)?

Parathyroidectomy (pair-uh-thigh-roid-EK-tuh-mee) refers to the surgical removal of one or more parathyroid glands. These tiny glands, located on the back of your thyroid, help regulate the level of calcium in your blood. (Most people have four parathyroid glands, but rarely, a person can have more, fewer or none.)

You might need parathyroidectomy surgery if you have hyperparathyroidism — when one or more of your parathyroid glands makes too much parathyroid hormone (PTH). Reasons for parathyroidectomy include:

• Parathyroid adenoma (a noncancerous growth on one or two of the parathyroid glands).
• Parathyroid hyperplasia (multiple enlarged parathyroid glands).
• Parathyroid cancer (very rare).

You can also develop hyperparathyroidism because of another medical condition. Kidney disease is a common example. When this happens, healthcare providers call it secondary hyperparathyroidism.

How should I prepare for parathyroidectomy (parathyroid surgery)?

Before your operation, your healthcare provider will give you instructions specific to your situation. Here are some questions to ask your provider before the day of your appointment:

• Will I need to fast the morning of my procedure?
• Should I take all my regular medications, vitamins and supplements?
• Do I need a friend or family member to drive me to and from my surgery appointment?

What happens during parathyroidectomy (parathyroid surgery)?

Surgeons use a few different approaches for parathyroidectomy, including traditional, minimally invasive and scarless (when they make an incision inside your mouth instead of on your neck). If your provider needs to make an incision on your neck, they’ll place it strategically (like in a natural crease) to hide the scar. Your surgeon will discuss your options and let you know what to expect the day of your procedure.

When you arrive for your parathyroid surgery, your surgeon will:

• Give you anesthesia to keep you comfortable.
• Make a small incision (in your neck or mouth, depending on the type of surgery you have) to locate your parathyroid glands.
• Remove the affected parathyroid glands.
• Close the incision with sutures.

Parathyroidectomy takes about one hour to complete in most cases.

What happens after parathyroidectomy (parathyroid surgery)?

After parathyroidectomy, you should be able to go home the same day or the day after. You’ll be able to eat and drink normally. But if you have a sore throat, you may want to eat soft foods for a day or two. You’ll also be able to walk around. But you should avoid strenuous exercise until your surgeon clears you.

Depending on your situation, you might need to take calcium supplements temporarily. This helps increase your blood calcium levels while your remaining parathyroid glands adjust and recover.

What are the benefits of having a parathyroid removed?

Parathyroidectomy can improve your quality of life in many ways. By returning your blood calcium levels to a healthy range, this procedure can reduce or eliminate symptoms of hyperparathyroidism, like:

• Joint pain.
• Muscle weakness.
• Nausea.
• Fatigue
• Foggy mind.

It also reduces your risk for related conditions, like:

• Kidney stones.
• Osteoporosis.
• Heart issues.

Are there risks associated with parathyroidectomy?

Parathyroidectomy is safe, in general. But like any surgical procedure, it comes with some risks. Possible short-term complications include:

• Sore throat.
• Hoarseness.
• Infection.
• Hematoma (a collection of blood under your skin).

If you develop any of these postsurgical parathyroidectomy side effects, your provider can treat them.

Long-term effects of parathyroidectomy

It’s possible to develop long-term side effects in some cases. The most common complications include:

• Hungry bone syndrome (chronic hypocalcemia). Long-term low calcium levels can occur if you have absent or damaged parathyroid glands.
• Recurrent (returning) hyperparathyroidism. You can develop hyperparathyroidism again if another parathyroid gland becomes overactive after your surgery. It can also happen if your surgeon can’t locate an overactive gland.

How long does parathyroidectomy recovery take?

Full recovery takes between one and three weeks. But you’ll be able to resume normal activities in a few days. Be sure to clear it with your surgeon before exercising.

What is the prognosis for parathyroidectomy?

Parathyroidectomy has impressive success rates (over 95%) in treating hyperparathyroidism. In fact, it’s the only available cure for the condition. Research indicates that less than 2% of people who undergo parathyroidectomy develop recurrence (return) of hyperparathyroidism.

When should I call my healthcare provider?

Following parathyroidectomy, call your healthcare provider if you develop:

• Fever over 101 degrees Fahrenheit (38.3 degrees Celsius).
• Pain that doesn’t improve with medication.
• Difficulty swallowing.
• Signs of infection around your incision like redness, discharge or increased warmth.
• Symptoms of low calcium like numbness, muscle cramps or fatigue.

If you have trouble breathing, call 911 (or your local emergency services number) or head to your nearest emergency room.

Is a parathyroidectomy a major surgery?

No, parathyroidectomy isn’t a major surgery. Even traditional parathyroid surgery only requires a small incision measuring about 2 inches (5 centimeters).

What happens when you have your parathyroid removed?

After parathyroidectomy, your remaining parathyroid glands might need time to recover. You may develop low levels of calcium (hypocalcemia), which can cause cramping or tingling. Usually, this only lasts a few weeks. Your surgeon can give you calcium supplements to take in the meantime.

A note from Cleveland Clinic

When your parathyroid glands make too much hormone, it can lead to hyperparathyroidism and several related symptoms. Parathyroidectomy is a common, minimally invasive procedure that can improve (and in many cases, cure) hyperparathyroidism. If you develop new symptoms like joint pain, muscle weakness, fatigue and foggy memory, it could indicate overactive parathyroid glands. Let your healthcare provider know so they can determine a cause and recommend appropriate treatment.