Parathyroid Surgery General Information The parathyroid glands are four tiny glands in the neck which are situated adjacent to the thyroid gland. They produce hormones which help control calcium levels in the body and to help distribute the calcium properly. Parathyroid surgery is usually necessary because of overactive parathyroid glands. There may be one overactive gland, or all of them may be overactive. If only one gland is overactive, only that gland will be removed. If all of the glands are overactive, then three and a half glands are removed, leaving half of one overactive gland in the body; this is typically enough to prevent problems. Complete loss of parathyroid hormone can cause severe lifelong symptoms, which is why some parathyroid tissue is always left behind. Parathyroid dysfunction is most often asymptomatic, although it can contribute to kidney stones, abdominal pain, and osteoporosis. When it is asymptomatic it is usually discovered during routine bloodwork which shows an elevated calcium level. Tests that will be done prior to surgery include a blood calcium check, a measurement of the parathyroid hormone (PTH) level, and a scans to help determine which gland(s) are responsible for the overproduction of PTH. These scans may include an ultrasound, a CT scan, or a nuclear medicine scan called a sestamibi scan. Tests will be ordered at the discretion of your surgeon. The surgery is done under general anesthesia and involves staying in the hospital overnight afterwards. The main risks involve injury to the nerves that control your voicebox. Your blood calcium level will be checked at least once postoperatively before sending you home. You may need to take calcium supplements temporarily after surgery. The Procedure When you arrive, you will go to the preoperative preparation area where a nurse will review your medical history and an IV will be started. If you haven’t already done so, you will meet with an anesthesiologist at this time. When the operating room is ready for you, you will be taken in on a stretcher and will meet the operating room nurses who will help take care of you during the procedure. If you didn’t see your surgeon in the preoperative area, you will see him in the operating room prior to the beginning of the procedure. You will then move onto the operating room table and the anesthesiologist will give you medication to make you fall asleep. Your surgeon will then perform the procedure while you are completely asleep. The surgery is done through an incision on your lower neck. Close monitoring of the parathyroid hormone (PTH) level is performed in the operating room to ensure the overactive gland(s) is/are removed. When the surgery is completed, you will be taken to the recovery area where you will slowly wake up and regain complete consciousness. A nurse will give you any medication you need and monitor your vital signs and pain level as you wake up. Your surgeon will speak to your friends or family members in the waiting room during this time. Postoperative Information Once you have recovered from anesthesia and your pain is controlled, you will be taken from the recovery area to a hospital room. You can expect to be mildly hoarse for several days as the nerves controlling the voicebox will be swollen. For more information on postoperative care, please click on this "Inpatient Surgery" link.