Parathyroid Surgery

Although the thyroid and parathyroid

glands are part of the body's endocrine

(hormone secretion system) system and are in

close proximity, their functions are very

different from each other.

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Parathyroid Surgery
Parathyroid Surgery

Parathyroid


The parathyroid glands are the most common of four located posterior to the thyroid gland. Each parathyroid gland is normally about 3-5 millimeters in diameter and weighs 30 - 60 milligrams. The parathyroid glands secrete parathyroid hormone (PTH), which controls calcium levels in the bloodstream. Parathormone is the most important hormone that regulates the balance of calcium and phosphorus, which are very important minerals for the body, in the tissues. In the body, especially the bones, kidneys, and small intestine, respond to PTH by increasing calcium levels in the blood.

 

How are parathyroid gland diseases treated?


Treatment of parathyroid gland diseases may differ. Different methods can be followed in the treatment of hyperparathyroidism, which means overproduction of the hormone, and hypoparathyroidism, which is caused by underproduction, with surgery and drug treatments.

 

Changes in blood calcium balance may cause various findings, but with the widespread use of routine blood tests, many patients without obvious findings can be diagnosed.

 

Hyperparathyroidism


It is 3 times more common in women than men. Hyperparathyroidism is common in women over 40 years of age. There is familiality in 20% of the cases.

Fatigue, rapid fatigue, bone and joint pain, decreased appetite, nausea, constipation, drinking a lot of water, urination, itching and depression are among the most common symptoms. In advanced cases, significant osteoporosis, bone fractures, kidney stones can be seen.

 

In blood tests, parathormone, calcium levels are high, phosphorus levels are low. There is a large amount of calcium excretion in the urine.
Diagnosis is made by blood and urine tests as well as ultrasonography and sestamibi scintigraphy.

 

Hyperparathyroidism treatment


In the treatment of hyperparathyroidism, the cause and degree of the disease determine the treatment planning.
Primary Hyperparathyroidism, that is, the cause of excess hormone production due to problems arising from the parathyroid gland itself is usually one or more of the parathyroid glands producing excess hormone.

 

The reason is the nodular enlargement of one (most common) or more of the parathyroid gland, which is most commonly called adenoma. 80-85% of cases have single parathyroid adenoma, 4-5% have double adenoma, 10-15% have multiple gland hyperplasia and less than 1% have parathyroid cancer.

 

Surgical removal of the enlarged gland is the most selective treatment method in its treatment.

 

Calcimimetic drugs, drugs containing vitamin D or hormone replacement therapies can be used to balance the calcium level in patients who are not suitable for parathyroid surgery. Which drug to use and dosages should be determined by the doctor who conducts the treatment process.

 

Treatment of Secondary Hyperparathyroidism varies depending on the underlying cause. The most common causes of secondary hyperparathyroidism are vitamin D deficiency and kidney diseases (chronic kidney diseases). Once the cause has been identified, treatment should be tailored to the cause. If the cause is vitamin D deficiency, replacement therapy should be planned. Permanent treatment of chronic kidney failure, which is the most common cause of secondary hyperparathyroidism, is provided by kidney transplantation. However, surgical methods such as drug treatments and removal of three and a half of four glands can be applied when necessary.

 

Hypoparathyroidism


Hypoparathyroidism is a rare disease. The disease usually occurs in adulthood and is more common in women.

Signs and symptoms of hypoparathyroidism due to the decrease in calcium levels in the blood, temporary or permanent

hypoparatia after thyroid surgeries; numbness-tingling in the hands, feet or around the mouth, uncontrollable painful muscle cramps in the face, hands and feet (a serious condition called advanced tetany), memory problems, headaches, extreme tiredness, anxiety or depression, epileptic seizures, heart rhythm are disorders.

 

Hypoparathyroidism Treatment


The aim of the treatment of hypoparathyroidism is to keep the calcium level in the blood within normal ranges and to alleviate the symptoms that occur as a result of hypoparathyroidism. For this purpose, calcium, vitamin D, magnesium or hormone replacement drugs, as prescribed by the doctor, can be used during the treatment process. In the treatment of hypoparathyroidism, it is important to regulate the patient's diet.

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