parathyroidectomy header

Information about this procedure is listed under the following headings:

Why do I need this operation?

What are the intended benefits of the surgery?

How is the surgery performed?

What are the potential risks and how great are these risks?

What am I to expect after the operation?

How long will I be off work/school?

Frequently asked Questions

Why do I need this operation?

The parathyroid glands are situated in the lower part of the neck on either side of the thyroid gland surrounding the windpipe (see picture). There are normally four glands, two on each side. Some people may have only three glands, some may have five. The parathyroid glands are responsible for controlling the levels of calcium in the blood. The hormone they produce - parathyroid hormone - raises the level of calcium in the blood. If these glands are overactive, the levels of calcium in the blood rises.

1) Hypercalcaemia - raised calcium levels in the blood. If these levels become very high, they may become dangerous.

2) Bone problems - as the level of calcium in the blood rises, bones are broken down to provide the extra calcium, weakening them.

3) Cancer of the parathyroid gland - this is very rare.

What are the intended benefits of the surgery?

If there is one gland producing excess parathyroid hormone, removal of this gland will make all symptoms disappear. Calcium levels in the blood will return to normal. If all the glands are stimulated to overproduce parathyroid hormone, removing all the glands will be necessary.

How is the surgery performed?

A general anaesthetic is administered. A horizontal skin incision (cut) is made in one of the skin creases in the neck. The parathyroid glands are identified and either one or all are removed. A surgical drain is inserted to allow any blood to drain.

What are the potential risks?

There are many potential risks involved in having a parathyroidectomy and some of these risks are very serious, but it is important to note that these risks are very uncommon.

1) Bleeding - As with any operation, there may be some bleeding from the site of the operation. This is drained using a surgical drain. The amount of bleeding is seldom serious enough to require a return to the operating theatre or a blood transfusion.

2) Scar - The site of the scar (see photograph) following a thyroid operation is low on the neck, and normally shrinks to an extent where is is difficult to see within a few months. If you are from an Afro-Caribbean background, you are at more risk of a keloid scar which may be more unsightly.

3) Damage to recurrent laryngeal nerve - this nerve supplies the vocal cords. If one is damaged during the operation, the result may be a hoarse voice or a weak voice. This may be temporary or permanent. The chance of the nerve being damaged is 1-2%. If the superior laryngeal nerve is injured, there may be difficulty in altering the pitch of your voice. This is seldom permanent.
4) Calcium replacement - if all the glands are removed, lifelong calcium replacement will be required. If only one is removed, this is not necessary.

What am I to expect after the operation?

The length of stay will depend on how well you progress after the surgery. A drain will be required for at least the first night, and when this has stopped draining, it can be removed, after which it is often possible to go home. Usually this is happens on the second day after the operation. Regular blood tests will be required to determine if the levels of calcium in the blood have returned to normal.

How long will I be off work / school?

The length of time off work is variable and will vary from one to two weeks depending on how soon you get back to normal following your surgery. A doctor's note will be provided.

Frequently asked Questions

Will the scar be very obvious?

The scar is on the front of the neck, but this often settles to become a barely noticeable white line.

Can anything be done if I have an injury to my recurrent laryngeal nerve?

If the nerve does not recover on its own, there are some simple surgical procedures that may be effective in improving your voice.


Last updated: 23 October 2004