There are usually four parathyroid glands located in the neck behind the thyroid gland.  Each gland is usually the size of a small pea (40-60mg).  These glands produce parathyroid hormone which helps maintain normal calcium levels in the blood.  Parathyroid hormone maintains blood calcium levels by increasing the amount of calcium absorbed in the intestines and kidneys and also increases calcium turnover in bones and as such may cause bone loss (weak bones).

Removal of the parathyroid glands is usually required if one or more glands inappropriately produces excessive amounts of parathyroid hormone or becomes cancerous.  Parathyroid surgery is usually performed through an incision on the front of the neck.  This incision can vary in length from one to three inches and is placed low in the neck (usually in a skin crease) to improve the cosmetic appearance of the scar.  Parathyroid surgery performed through smaller incisions (directed parathyroidectomy) can also offer improved cosmetic appearance, and be performed as an out-patient procedure.

Most patients are admitted to the hospital on the day of the operation.  You may be asked to temporarily stop taking certain medications or take new medications prior to surgery.

Parathyroidectomy is a safe and effective procedure.  There are few specific complications of parathyroid surgery.  These may include damage to nerves supplying the vocal cords and inadequate function of the remaining parathyroid glands after surgery. The former complications may cause voice hoarseness or breating difficulty, whereas the latter can usually be managed by life-long calcium replacement.  When identified during surgery, nerve injuries can be repaired and damaged parathyroid glands can be transplanted into the neck or forearm. 

Since most people have four functioning parathyroid glands, the removal of one gland does not usually require long-term calcium supplementation, although if the hyperactive parathyroid gland suppresses the function of the other glands, it may require several months for the remaining glands to regain function.  You may require calcium and/or vitamin D supplements during that period.  Total removal of parathyroid glands and transplantation would require long-term calcium and vitamin D replacement until the parathyroid transplant regains function.

Our Surgeons

Shelby Holt, M.D.
Fiemu Nwariaku, M.D.