Most people have four tiny parathyroid glands which typically lie behind each lobe of the thyroid gland in upper and lower positions. These glands produce parathyroid hormone, a substance which regulates calcium levels. Primary hyperparathyroidism describes a condition where one, two or all these glands inappropriately secrete too much parathyroid hormone. This excess hormone results in high blood calcium levels which can cause numerous symptoms, some of which may go unnoticed.
Most patients with primary hyperparathyroidism have one gland which enlarges and is dysfunctional due to a benign parathyroid adenoma. Less commonly, all glands are overactive, known as hyperplasia. Parathyroid cancer is rare. Normal parathyroid glands cannot be felt or seen on imaging, and it would be very unusual to feel even an enlarged parathyroid gland. However, modern imaging can successfully localise an overactive gland due to a single adenoma in many patients. Minimally invasive parathyroidectomy may be offered to cure this problem. A small incision is made directly over the parathyroid tumour (localised in theatre with ultrasound). Identification of the gland deep to the muscles and thyroid gland, usually takes a few minutes but on occasion further dissection in the neck is necessary. Some patients with primary hyperparathyroidism are unsuitable for a minimally invasive approach and require both sides of the neck to be explored.
Joanna is an experienced parathyroid surgeon. For those patients undergoing minimally invasive parathyroidectomy, Joanna has the advantage of using her own ultrasound to confirm and verify precisely the location of a parathyroid adenoma. This facilitates surgery by minimising dissection in the neck.
Australia and New Zealand Endocrine Surgeons
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