Parathyroidectomy is surgery to remove the parathyroid glands or parathyroid tumors. The parathyroid glands are right behind your thyroid gland in your neck. These glands help your body control the calcium level in the blood.
You will receive general anesthesia (asleep and pain-free) for this surgery.
Usually the parathyroid glands are removed using a 2- to 4-inch (5- to 10-cm) surgical cut on your neck. During surgery:
- The cut is usually made in the center of your neck just under your Adam's apple.
- Your surgeon will look for the four parathyroid glands and remove any that are diseased.
- You may have a special blood test during surgery that will tell if all the diseased glands were removed.
- In rare cases, when all four of these glands need to be removed, part of one is transplanted into the forearm. Or, it is transplanted into a muscle in the front of your neck next to the thyroid gland. This helps ensure your body's calcium level stays at a healthy level.
The specific type of surgery depends on where the diseased parathyroid glands are. Types of surgery include:
- Minimally invasive parathyroidectomy. You may receive a shot of a very small amount of radioactive tracer before this surgery. This helps highlight the diseased glands. If you have this shot, your surgeon will use a special probe, like a Geiger counter, to locate the parathyroid gland. Your surgeon will make a small cut (1 to 2 inches; or 2.5 to 5 cm) on one side of your neck, and then remove the diseased gland through it. This procedure takes about 1 hour.
- Video-assisted parathyroidectomy. Your surgeon will make two small cuts in your neck. One is for instruments, and the other is for a camera. Your surgeon will use the camera to view the area and will remove the diseased glands with the instruments.
- Endoscopic parathyroidectomy. Your surgeon will make two or three small cuts in the front of your neck and one cut above the top of your collarbone. This reduces visible scarring, pain, and recovery time. This cut is less than 2 inches (5 cm) long. The procedure to remove any diseased parathyroid glands is similar to video-assisted parathyroidectomy.
Why the Procedure is Performed
Your health care provider may recommend this surgery if one or more of your parathyroid glands is producing too much parathyroid hormone. This condition is called hyperparathyroidism. It is often caused by a small non-cancerous (benign) tumor called an adenoma.
Your surgeon will consider many factors when deciding whether to do surgery and what type of surgery would be best for you. Some of these factors are:
- Your age
- Calcium levels in your urine and blood
- Whether you have symptoms
Risks for anesthesia and surgery in general are:
- Reactions to medicines or breathing problems
- Bleeding, blood clots, or infection
Risks for parathyroidectomy are:
- Injury to the thyroid gland or the need to remove part of the thyroid gland.
- Hypoparathyroidism. This can lead to low calcium levels that are dangerous to your health.
- Injury to the nerves going to the muscles that move your vocal cords. You may have a hoarse or weaker voice which could be temporary or permanent.
- Difficulty breathing. This is very rare and almost always goes away several weeks or months after surgery.
Before the Procedure
Parathyroid glands are very small. You may need to have tests that show exactly where your glands are. This will help your surgeon find your parathyroid glands during surgery. Two of the tests you may have are a CT scan and an ultrasound.
Tell your surgeon:
- If you are or might be pregnant
- What medicines, vitamins, herbs, and other supplements you're taking, even ones you bought without a prescription
During the week before your surgery:
- Fill any prescriptions for pain medicine and calcium you'll need after surgery.
- You may be asked to stop taking blood thinners. These include NSAIDs (aspirin, ibuprofen), vitamin E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and clopidegrel (Plavix).
- Ask your surgeon which drugs you should still take on the day of your surgery.
On the day of your surgery:
- Follow instructions about not eating and drinking.
- Take the medicines your surgeon told you to take with a small sip of water.
- Arrive at the hospital on time.
After the Procedure
Often, people can go home the same day they have surgery. You can start your everyday activities in a few days. It will take about 1 to 3 weeks for you to fully heal.
The surgery area must be kept clean and dry. You may need to drink liquids and eat soft foods for a day.
Call your surgeon if you have any numbness or tingling around your mouth in the 24 to 48 hours after surgery. This is caused by low calcium. Follow instructions about how to take your calcium supplements.
After this procedure, you should have routine blood tests to check your calcium level.
People usually recover soon after this surgery. Recovery may be fastest when less invasive techniques are used.
Sometimes, another surgery is needed to remove more of the parathyroid glands.
Removal of parathyroid gland; Parathyroidectomy; Hyperparathyroidism - parathyroidectomy; PTH - parathyroidectomy
Coan KE, Wang TS. Primary Hyperparathyroidism. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:779-785.
Quinn CE, Udelsman R. The parathyroid glands. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 37.
Review Date 9/28/2020
Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
NIH MedlinePlus MagazineRead more
What happens if you have to have your parathyroid glands removed? ›
After parathyroid glands are removed, the remaining parathyroid glands may take some time to work properly again. This, along with uptake of calcium into bones, can lead to low levels of calcium — a condition called hypocalcemia. You may have of numbness, tingling or cramping if your calcium level gets too low.How long does it take to recover from parathyroid removal? ›
It will take about 1 to 3 weeks for you to fully heal. The surgery area must be kept clean and dry. You may need to drink liquids and eat soft foods for a day. Contact your surgeon if you have any numbness or tingling around your mouth in the 24 to 48 hours after surgery.Is parathyroid surgery a big deal? ›
The complications from parathyroid surgery are serious, and typically WORSE than the disease. Complications are MUCH more common in general surgeons (and ENT surgeons) who do 35 or fewer parathyroid operations per year.Who is the best parathyroid surgeon in the United States? ›
James (Jim) Norman, MD, FACS, FACE. Dr. Jim Norman founded of the Norman Parathyroid Center in 2003, and is recognized as one of world's foremost experts on parathyroid disease and he has treated more parathyroid patients than any other doctor.Is there an alternative to parathyroid surgery? ›
That's why we offer MIP as an alternative to conventional parathyroidectomy, which is done under general anesthesia and requires an incision about 1 to 2 inches long. During MIP, the patient receives mild sedation and localized pain relief, and the surgeon makes a 2- to 3-centimeter incision.Does memory improve after parathyroid surgery? ›
A remarkable improvement after parathyroidectomy at all levels was observed: movement, memory, attention, concentration, and general quality of life.Why do I feel worse after parathyroid surgery? ›
A: It's common for the body to take several weeks to regulate the parathyroid hormone levels. Over the course of the next couple of months, you may feel slight discomfort, lethargic, and even crampy as your blood calcium level evens out.How painful is parathyroid surgery? ›
At the time of operation, your surgeon will give you some numbing medicine which usually lasts about eight hours. Although you should be able to eat and drink normally, the main complaint is pain with swallowing. Most patients take Tylenol® or Motrin® to keep them comfortable at home.How long do I have to take calcium after parathyroid surgery? ›
Finally, after a parathyroid operation, everyone needs to take calcium for at least 6 months.What is the best hospital for parathyroid surgery? ›
The Norman Parathyroid Center is the world's leading parathyroid surgery center performing an average of 72 parathyroid operations per week.
What is the success rate of parathyroid surgery? ›
First, most parathyroid operations are straightforward and can be completed with an excellent success rate by surgeons who perform parathyroid surgery more than once per month. Second, the role of the expert parathyroid surgeon is to raise the success rate from 90-95% long-term to 97-99% long-term.How much does parathyroid surgery cost in USA? ›
On MDsave, the cost of a Parathyroidectomy ranges from $8575 to $11756. Those on high deductible health plans or without insurance can shop, compare prices and save. Read more about how MDsave works.Can you avoid parathyroid surgery? ›
While many patients elect to undergo surgery so that they do not develop complications from their parathyroid disease, some patients may have mildly elevated calcium levels and mild complications from their disease. Some patients may decide not to have surgery in this situation, which is acceptable.Can you talk after parathyroid surgery? ›
You may have some trouble chewing and swallowing after you go home. Your voice probably will be hoarse, and you may have trouble talking. For most people, these problems get better within a few weeks, but it can take longer. In some cases, this surgery causes permanent problems with chewing, speaking, or swallowing.How complicated is parathyroid surgery? ›
Because of the numerous small nerves and other important structures within the neck which reside around the parathyroid glands, the 'standard' parathyroid operation can be technically challenging and has the best results when performed by experienced endocrine (parathyroid) surgeons or surgeons with extensive head and ...What are the benefits of removing parathyroid? ›
What are the benefits of this procedure? You will no longer have high calcium levels in your blood. The abnormal parathyroid gland(s) have been removed. By eliminating the high calcium level in your blood, you will be protected from the short- and long-term consequences of calcium elevation.What foods should you avoid if you have parathyroid? ›
Avoid refined foods, such as white breads, pastas, and sugar. Use healthy cooking oils, such as olive oil or coconut oil. Reduce or eliminate trans-fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, and donuts, French fries, onion rings, processed foods, and margarine.How can I lower my parathyroid naturally? ›
Exercise Regularly. A low level of physical activity can increase the risk of HPT symptoms. Therefore, developing and following an exercise regimen may help people reduce their risk of HPT. Of course, HPT patients can engage in regular exercise to help strengthen the bones by putting pressure on them.Does bone density improve after parathyroid surgery? ›
They reported that parathyroid surgery for patients with severe primary hyperparathyroidism resulted in significant increases in bone mineral density that were measurable 1 year after surgery and continued for the next 10 years.Does depression go away after parathyroid surgery? ›
After these patients underwent a parathyroidectomy to treat HPT, 90% said their depression symptoms no longer impacted their ability to work or perform other daily activities. Additionally, 52% reported improved quality of life after their parathyroidectomy.
Does parathyroid affect sleep? ›
There's actually some preliminary data to show that patients with parathyroid disease do actually have higher rates of disordered sleep or insomnia, and that's mostly done by sleep questionnaires.How long will my neck be sore after parathyroid surgery? ›
Patients typically take between 5 – 7 days off work following parathyroid surgery. Most patients feel back to “normal” by two weeks after surgery. You may drive once you are no longer taking narcotic pain medications and feel comfortable turning your neck, usually about 3 days.How long does throat hurt after parathyroidectomy? ›
This is normal to experience after surgery and will often last up to 5 days after surgery. Lozenges and a softer diet may be helpful until this resolves. You may also feel like you have phlegm in your throat and need to cough. This is due to the irritation of the tube in your windpipe during surgery.
After surgery, you will have a soft drain in the surgical incision, which prevents fluid and blood from building up in the wound. The drain will be removed once there is minimal drainage.Are you awake during parathyroid surgery? ›
Most parathyroidectomies take place while the person is under general anesthesia, asleep and pain-free. The surgeon makes a small incision in the skin of the neck and parts a thin layer of muscle to gain access to the thyroid gland and the parathyroid glands behind it.How long does a parathyroid surgery take? ›
The parathyroidectomy procedure can take anywhere from 30 minutes to three hours once you are asleep. It depends on how quickly we can find and confirm the removal of the abnormal gland. How long will I be hospitalized? Almost all patients that undergo a parathyroidectomy will go home that same day.What problems can you have after parathyroid surgery? ›
Temporary hoarseness, voice tiring, and weakness can occur when one or more of the nerves are irritated during the operation or because of inflammation that occurs after the surgery. This usually gets better within a few weeks, but can take up to 6 months to resolve.What medication do you take after parathyroid surgery? ›
Calcium (TUMS): After parathyroid surgery, all patients are discharged home with calcium supplementation. Parathyroid glands regulate calcium levels in the blood. The calcium is necessary due to removal of the overactive gland and the remaining “sleepy” parathyroid glands.Should I take vitamin D after parathyroidectomy? ›
Effects of Vitamin D
It has been suggested that patients with primary hyperparathyroidism often have low vitamin D levels and require vitamin D supplementation after parathyroidectomy to maintain normal calcium levels.
Parathyroid glands control the amount of calcium in your blood. Parathyroid glands control the amount of calcium in your bones. You can easily live with one (or even 1/2) parathyroid gland. Removing all 4 parathyroid glands will cause very bad symptoms of too little calcium (hypOparathyroidism).
Can you live a long life with parathyroid disease? ›
Most people with asymptomatic primary hyperparathyroidism can have a fairly benign course for years, even a lifetime. But hyperparathyroidism does progress in some people, and they should undergo surgery, which is the only complete cure.What are the signs and symptoms of parathyroid disease? ›
- A lump in the neck.
- Difficulty speaking or swallowing.
- Muscle weakness.
- Sudden increase in blood calcium levels (hypercalcemia)
- Fatigue, drowsiness.
- Urinating more than usual, which may cause you to be dehydrated and very thirsty.
- Bone pain and broken bones.
- Kidney stones.
Avoid refined foods, such as white breads, pastas, and sugar. Use healthy cooking oils, such as olive oil or coconut oil. Reduce or eliminate trans-fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, and donuts, French fries, onion rings, processed foods, and margarine.Does parathyroid cause dementia? ›
Hyperparathyroidism, characterized by elevated/high PTH levels, has been associated with many chronic conditions including impaired cognitive function and dementia [8–11].Can parathyroid affect your heart? ›
Patients with disorders of the parathyroid gland have higher incidences of hypertension, arrhythmias, left ventricular hypertrophy, heart failure, and calcific disease which translate into increased cardiac morbidity and mortality.How high is too high for parathyroid? ›
Their calcium is high (typically around 10.5 to 11.6) but their PTH levels are still in the "normal" range. Most of these patients have PTH levels between 40 to 60. If your calcium is frequently or persistently high, and your PTH isn't below 25, then you very likely have hyperparathyroidism.What is the most common cause of parathyroid? ›
A noncancerous growth (adenoma) on a gland is the most common cause. Enlargement (hyperplasia) of two or more parathyroid glands accounts for most other cases. A cancerous tumor is a very rare cause of primary hyperparathyroidism.