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WHAT IS A PARATHYROIDECTOMY?
A parathyroidectomy is surgery to remove one or more overactive parathyroid glands. Most people have four of these small glands, each about the size of a grain of rice, behind the thyroid gland in the neck. They control the calcium level in your blood. When a gland grows and makes too much parathyroid hormone, calcium rises, a condition called hyperparathyroidism. Removing the abnormal gland is the only cure for primary hyperparathyroidism. At North Florida Surgeons in Jacksonville, FL, most parathyroid operations are done through a small neck incision as outpatient surgery.
WHY CHOOSE US?
Parathyroid surgery at North Florida Surgeons is led by Dr. Courtland Polley. Before the operation we use imaging to find the overactive gland, so the surgeon can remove it through a small incision while protecting the nerves to your voice.
About 80 percent of our parathyroid patients have outpatient surgery and go home the same day.
Before surgery, we review your calcium and parathyroid hormone levels, bone density and kidney health.
WHEN IS PARATHYROID SURGERY RECOMMENDED?
PRIMARY HYPERPARATHYROIDISM
In most patients a single benign growth, called a parathyroid adenoma, causes the problem. Less often, all four glands are enlarged. Very rarely, the cause is parathyroid cancer.
SYMPTOMS OF HIGH CALCIUM
High calcium can cause fatigue, bone and joint pain, kidney stones, frequent thirst and urination, stomach upset, poor memory, low mood and trouble sleeping. Some people have no symptoms and are found on a routine blood test.
WHO SHOULD HAVE SURGERY
Surgery is recommended for anyone with symptoms, and for people without symptoms who have a high calcium level, kidney stones, kidney damage, bone loss or osteoporosis, or who are younger than 50.
PARATHYROID OR THYROID?
The parathyroid glands sit next to the thyroid but have a different job: they control calcium, while the thyroid controls metabolism. Read thyroid vs. parathyroid or see our thyroid and parathyroid surgery services.
RISKS TO KNOW
Problems are uncommon. The most common is a temporary drop in calcium after surgery, which causes tingling and is treated with calcium tablets. Hoarseness, bleeding and a persistent high calcium level are rare.
HOW THE SURGERY IS DONE
FINDING THE GLAND
A sestamibi scan, a neck ultrasound or a 4D CT scan shows which gland is overactive before surgery. This allows a smaller, focused operation in most patients.
FOCUSED PARATHYROIDECTOMY
Through a small incision in a neck crease, the surgeon removes the overactive gland. Parathyroid hormone may be measured during the operation to confirm that the problem gland is gone. The operation often takes about an hour.
FOUR-GLAND EXPLORATION
When imaging is unclear or more than one gland is affected, the surgeon examines all four glands and removes the abnormal ones, leaving enough healthy tissue to keep your calcium normal.
WHAT TO EXPECT
BEFORE SURGERY
You will have blood tests of calcium, parathyroid hormone and vitamin D, imaging to find the gland and sometimes a bone density scan. Tell us about all your medicines, especially blood thinners. See our checklist for general surgery.
THE DAY OF SURGERY
Most patients go home the same day, a few hours after surgery. A sore throat and mild neck discomfort are normal for a few days.
CALCIUM AFTER SURGERY
Calcium can drop for a short time as the remaining glands wake up and the bones take calcium back. Your surgeon may prescribe calcium supplements for a few weeks. Call us if you feel tingling around the mouth or in the fingers or have muscle cramps. Read about low calcium after parathyroid surgery.
RECOVERY
Most people return to normal activities within a few days to a week. Many patients notice more energy, better sleep and less pain in the weeks after surgery, and bone density often improves over time.
OUR PARATHYROID SURGEON
Parathyroidectomy at North Florida Surgeons is performed by Dr. Courtland Polley, a board-certified general surgeon. You can also meet all our surgeons.
PARATHYROIDECTOMY FAQS
Is parathyroid surgery the only cure for hyperparathyroidism?
For primary hyperparathyroidism, yes. Medicines can lower calcium for a time, but removing the overactive gland is the only treatment that cures it, and it succeeds in more than 95 percent of patients.
How long does parathyroid surgery take?
A focused operation to remove one gland often takes about an hour. A four-gland exploration takes longer.
Will I need to take medication after parathyroid surgery?
Most patients do not need long-term medication. Some take calcium and vitamin D for a few weeks while the remaining glands recover.
What is the recovery time after parathyroid surgery?
Most patients go home the same day and return to normal activities within a few days to a week. Avoid heavy lifting for about a week.
Can hyperparathyroidism come back after surgery?
It is uncommon. A small number of patients, especially those with more than one abnormal gland, develop high calcium again, so your calcium is checked after surgery and then periodically.
Does insurance cover parathyroid surgery?
Parathyroid surgery is usually covered when it is medically necessary, but coverage depends on your plan. See the insurance plans we accept or call our office.
Which type of surgery will I need?
It depends on your imaging. When the scans show one overactive gland, a focused operation removes that gland through a small incision. When the scans are unclear or more than one gland is involved, the surgeon explores all four parathyroid glands and removes the abnormal gland or glands.
How do I schedule a parathyroid surgery consultation in Jacksonville?
Call (904) 398-0033 or use the contact form. Our office is at 836 Prudential Dr., Suite 1001, Jacksonville, FL 32207. Related: thyroidectomy, thyroid and parathyroid surgery.
