Why Choose Cedars-Sinai Marina del Rey Hospital for Parathyroidectomy?
Cedars-Sinai Marina del Rey Hospital is the perfect environment where you can regain your health. Regardless of the type of hyperparathyroidism you are suffering from, our expert surgeons can consult you in making the best decision regarding your well-being. Every patient that goes through a parathyroidectomy at our facility benefits of the care provided by one of the most skilled medical staff in Los Angeles.
Parathyroidectomy is a surgical procedure, which implies the extirpation of one or both of the pairs of the parathyroid glands. In most of the cases, parathyroidectomies are performed on patients suffering from primary hyperparathyroidism. Hyperparathyroidism is a disease caused by the excess of parathyroid hormone, which leads to the removal of the calcium from the bones and to an increased absorption of calcium in the blood.
The surgical excision of the abnormal parathyroid glands is the only treatment for primary hyperparathyroidism and is recommended for all symptomatic patients. The main symptoms that doctors take into account before suggesting this procedure are the following:
- increase of serum calcium (more than 1mg/dl over the normal upper limit)
- excess of calcium urinary excretion in 24 hours
- reduction of the creatinine clearance with 30%
- osteodensiometry score lower than -2.5 regardless of the scanning place
- age bellow 50
If all the parathyroid glands are affected, the doctor will perform a total parathyroidectomy using parathyroid tissue from the sternocleidomastoid muscle. The parathyroid glands will be removed and a graft will be made using the excised tissue (it will contain about 50-70 milligrams of parathyroid tissue). Even though the mass of the tissue that the patient has at the end of the procedure is reduced, in 95% of the cases it has a normal function and is capable to produce the necessary quantity of parathyroid hormone. Also, the risk of a relapse of the disease is small.
Regardless of the type of hyperparathyroidism, there are more procedures that can be performed according to the severity of the affection and the localization of the glands:
- Video-assisted parathyroidectomy: consists in making two small incisions at the level of the anterior cervical region, one for the surgical instruments and the other for the guiding camera
- Minimally invasive parathyroidectomy: this procedure is the most frequent and is possible only in the cases of a unilateral affection
- Endoscopic parathyroidectomy: consists in making 3 incisions in the anterior cervical region and a fourth one above the clavicle.
- recurrent laryngeal nerve responsible for phonation injury (one in 2000 cases) as it is situated near the parathyroid and thyroid glands
- voice modifications
- bleeding is a rare complication but it can appear
- low values of calcium as after the extirpation of the parathyroid glands, it can take a few days before the other glands start functioning normally
- scars can become red and slightly thickened for a couple of months after the surgery, before it becomes white and thin
When the procedure is over, patients are taken to the recovery room and are monitored for one hour. Most of the times, they spend one night at the hospital even though when a minimally invasive parathyroidectomy is performed they can go home on the same day. Patients might feel that the neck is bruised and swollen after the surgery; a bandage will be wrapped around it, which can be removed after a day or two.