Parathyroidectomy (Parathyroid Surgery)

What Are the Parathyroid Glands?

The parathyroid glands are four small glands located behind the thyroid in the neck. They regulate calcium levels in the blood, which is essential for proper function of bones, muscles, and nerves.

Why Is Surgery Needed?

Parathyroid surgery is most commonly recommended for hyperparathyroidism, a condition in which one or more glands become overactive and produce excess hormone.

This can lead to:

• Elevated blood calcium levels
• Kidney stones
• Bone loss (osteoporosis)
• Fatigue or weakness
• Abdominal discomfort
• Mood or memory changes

Surgery is the most effective treatment for this condition.

What Is a Parathyroidectomy?

A parathyroidectomy is a procedure to remove the abnormal parathyroid gland(s) while preserving the normal glands.

How Is the Procedure Performed?

• Performed under general anesthesia
• A small incision is made in the lower front of the neck
• The surgeon identifies and removes the overactive gland(s)
• Preoperative imaging may allow for a focused or minimally invasive approach
• Remaining healthy glands continue to regulate calcium
• Procedure time is typically 1–2 hours

What to Expect After Surgery

Immediately After Surgery

• You may feel tired or groggy from anesthesia
• Assistance is recommended when first getting out of bed
• Neck soreness and stiffness are common
• Mild sore throat or hoarseness may occur from the breathing tube

Diet and Activity

• Resume a regular diet as tolerated (soft foods may be easier initially)
• Normal head movement is allowed
• Showering is permitted after 24 hours

Incision Care

• Gently wash with mild soap and water; do not scrub
• Pat dry
• Dermabond typically peels off within 7–10 days

Pain Management

• Usually managed with:
  • Ibuprofen (Motrin, Advil)
  • Acetaminophen (Tylenol)
• Stronger medication may be prescribed if needed
• Throat lozenges or spray may help sore throat

Calcium Management

• Calcium levels will be monitored
• Temporary calcium supplementation may be prescribed
• Some patients may experience temporary tingling in fingers or lips
• If you experience tingling, you can take TUMS over-the-counter, 3 tablets twice daily for 2 weeks

Recovery

• Most patients go home the same day or next morning
• Return to normal activities within a few days to one week
• Return to work typically within 7–10 days
• Avoid strenuous activity for 1–2 weeks

Incision Healing

• Skin becomes watertight within 24–36 hours
• OK to shower normally after 24 hours
• Full healing occurs over several weeks
• Mild swelling or firmness may last a few months
• Scars are most noticeable at 1–2 months, then gradually fade

Scar Care:

• Use sunscreen to prevent darkening (hyperpigmentation)
• Optional: vitamin E or moisturizer

Activity Guidelines

• Resume normal routine as soon as comfortable
• Driving is allowed when:
  • You can turn your head comfortably
  • You are not taking narcotic pain medication
• Gentle neck movement is encouraged to reduce stiffness
• Temporary numbness near the incision is common and may improve over time
• Mild neck fullness or swallowing difficulty may last 4–6 weeks

Benefits of Surgery

• Normalization of calcium levels
• Reduced risk of kidney stones
• Improved bone health
• Increased energy and overall well-being

Risks

Parathyroid surgery is generally very safe. Possible risks include:

• Bleeding or infection
• Temporary low calcium levels (most common)
• Hoarseness or voice changes (rare)
• Need for additional surgery if abnormal glands remain

Follow-Up

• Typically scheduled 2 weeks after surgery
• Confirm appointment with your surgeon’s office if needed

When to Call Your Doctor

Contact your doctor if you experience:

• Fever over 102°F not responding to medication
• Sudden increase in neck swelling
• Difficulty breathing
• Worsening tingling or numbness despite calcium supplementation
• Severe muscle cramping or spasms

Emergency Room Guidelines

• Age 16 and older: Centennial Medical Center Frisco
• Under age 16: Children’s Medical Center Plano