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Parathyroid Surgery

Dr Anthony Chambers specialises in surgery for the Parathyroid Glands.

The Parathyroid Glands are located in the lower neck.  There are four glands in total – two on each side.  They are located near the thyroid gland, but have a completely separate function. 

Parathyroid glands produce the hormone Parathyroid Hormone (PTH).  This hormone controls the level of calcium in the bloodstream. 

Normally the glands are small, measuring less than 6 to 8 millimetres in size. 

Primary Hyperparathyroidism

Surgery to remove a parathyroid gland is sometimes required when one or more glands have become enlarged and are producing an excessive amount of Parathyroid Hormone.  This condition is known as Primary Hyperparathyroidism. 

Primary Hyperparathyroidism is an uncommon condition, affecting only 1 in 1000 females at some stage of their lives, and only 1 in 10000 males.  The cause of this condition is unknown.

When a parathyroid gland enlarges and produces too much Parathyroid Hormone, this leads to high levels of calcium in the circulation.  This can lead to kidney stones and weakness of the bones (osteoporosis).  Other symptoms can include mood changes, fatigue and tiredness, difficulty concentrating, aches and pains in the muscles, bones and joints, thirst and frequent urination. 

The treatment for Primary Hyperparathyroidism is surgery to remove the Parathyroid gland (or glands) that are enlarged and overactive.  There are currently no medications that can treat Primary Hyperparathyroidism. 

Prior to any surgery, all four parathyroid glands are assessed to work out which ones are enlarged.  This involves an ultrasound scan as well as a sestamibi parathyroid scan.  These tests assist the surgeon to successfully locate and remove the enlarged gland at the time of the operation. 

As even an enlarged parathyroid gland can be difficult to find during surgery, the main risk of the operation is failure to find and remove the enlarged gland or glands.   This can occur in up to 5% of cases.