Parathyroid Surgery for Hyperparathyroidism
Hyperparathyroidism Treatment in Lucknow
Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body’s four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck.
The parathyroid glands produce parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning.
Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism.
Secondary hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur.
Hyperparathyroidism is often diagnosed before signs or symptoms of the disorder are apparent. When symptoms do occur, they’re the result of damage or dysfunction in other organs or tissues due to high calcium levels circulating in the blood and urine or too little calcium in bones.
Symptoms may be so mild and nonspecific that they don’t seem at all related to parathyroid function, or they may be severe. The range of signs and symptoms include:
Hyperparathyroidism is caused by factors that increase the production of parathyroid hormone.
The parathyroid glands maintain proper levels of both calcium and phosphorus in your body by turning the secretion of parathyroid hormone (PTH) off or on, much like a thermostat controls a heating system to maintain a constant air temperature. Vitamin D also is involved in regulating the amount of calcium in your blood.
Normally, this balancing act works well. When calcium levels in your blood fall too low, your parathyroid glands secrete enough PTH to restore the balance. PTH raises calcium levels by releasing calcium from your bones and increasing the amount of calcium absorbed from your small intestine
When blood-calcium levels are too high, the parathyroid glands produce less PTH. But sometimes one or more of these glands produce too much hormone, leading to abnormally high levels of calcium (hypercalcemia) and low levels of phosphorus in your blood.
The mineral calcium is best known for its role in keeping your teeth and bones healthy. But calcium has other functions. It aids in the transmission of signals in nerve cells, and it’s involved in muscle contraction. Phosphorus, another mineral, works in conjunction with calcium in these areas.
The disorder can generally be divided into two types based on the cause. Hyperparathyroidism may occur because of a problem with the parathyroid glands themselves (primary hyperparathyroidism) or because of another disease that affects the glands’ function (secondary hyperparathyroidism).
If the result of a blood test indicates you have elevated calcium in your blood, your doctor will likely repeat the test to confirm the results after you have not eaten for a period of time (fasted).
A number of conditions can raise calcium levels, but your doctor can make a diagnosis of hyperparathyroidism if blood tests show you also have elevated parathyroid hormone.
Additional diagnostic tests
Bone mineral density test (bone densitometry)
Imaging tests of kidneys
Imaging tests before surgery
Sestamibi parathyroid scan
Surgery is the most common treatment for primary hyperparathyroidism and provides a cure in about 95 percent of all cases. A surgeon will remove only those glands that are enlarged or have a tumor (adenoma).
If all four glands are affected, a surgeon will likely remove only three glands and perhaps a portion of the fourth â€” leaving some functioning parathyroid tissue.
Surgery may be done as an outpatient procedure, allowing you to go home the same day. In such cases, the surgery can be done through very small incisions in the neck, and you receive only local anesthetics.