If a patient is dealing with hyperparathyroidism (HPT) that impacts their quality of life, parathyroid gland surgery may be recommended to correct this problem. Or, if a patient is coping with HPT but is asymptomatic and experiences no kidney stones or bone loss (osteopenia or osteoporosis), monitoring can be used to determine if parathyroid surgery may be required at a later time.
Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery only conducts parathyroid surgery on patients whom he deems will benefit from it. For HPT patients who are uncertain about whether to pursue parathyroid surgery, Dr. Larian provides answers to common questions surrounding surgery.
Why Is Parathyroid Surgery Necessary?
Parathyroid gland surgery may be necessary if a patient is dealing with severe symptoms of HPT. If HPT symptoms make it difficult for people to work, go to school, or perform other normal activities, they can negatively impact quality of life. At this point, HPT patients may undergo surgery to achieve long-lasting symptomatic relief.
When Is Parathyroid Surgery Necessary?
To determine if parathyroid gland surgery is necessary, it is important to first meet with a doctor. Here, a patient can find out if one or more abnormal parathyroid glands is causing HPT symptoms.
When a parathyroid gland malfunctions, it can cause an imbalance of calcium in the body. If too much calcium is present in the body, the body’s PTH level increases. Or, if too little calcium is present, additional PTH enters the body. In cases where a parathyroid gland malfunctions, however, the body cannot effectively control PTH production. Since a defective parathyroid gland is unable to monitor the body’s calcium level properly, people can experience HPT symptoms that range in terms of severity.
HPT symptoms can be similar to those associated with other medical conditions. As such, the symptoms of HPT can be tough to diagnose and treat. These symptoms can even lead people to forgo treatment, as they may believe that the symptoms are associated with other medical conditions.
If HPT symptoms occur, it is recommended to consult with a doctor. Parathyroid surgery won’t be recommended at this time. Instead, a physical evaluation can be used to assess a patient’s symptoms. Various tests can also be performed to determine if a patient’s calcium level is normal and if one or more parathyroid glands may be malfunctioning.
What Tests are Used to Determine if a Parathyroid Gland Is Defective?
In the event that a doctor believes a patient is coping with HPT, localization studies are used to verify the location of any defective parathyroid glands. Localization studies include:
1. Ultrasound
An ultrasound is the first study used to identify an abnormal parathyroid gland. It is performed by a radiologist, endocrinologist, or parathyroid surgeon. It involves the use of sound waves to examine the structures beneath a patient’s skin.
Patients can undergo an ultrasound for an evaluation of the thyroid, parathyroid muscles, and blood vessels. Additionally, an ultrasound can be performed immediately following an HPT diagnosis. Once an ultrasound confirms the location of any abnormal parathyroid glands, patients can begin treatment.
2. Sestamibi Scan
A sestamibi scan is used to determine the location of a parathyroid adenoma. During the scan, a patient receives a small amount of radioactive dye, which travels to any abnormally functioning parathyroid glands.
The radioactive dye used in a sestamibi scan is quickly absorbed by a defective parathyroid gland; the dye leaves the body within a few hours. However, sestamibi scan results can be inaccurate if the test is performed by inexperienced radiologists. There can also be instances where a defective parathyroid gland is too small or other issues can arise that limit the scan’s effectiveness.
3. Single-Photon Emission Computed Tomography (SPECT) Scan
A SPECT scan combines sestamibi and CT scans. Together, these scans produce images that can be used to pinpoint the precise location of a malfunctioning parathyroid gland.
SPECT scans provide greater accuracy than sestamibi or CT scans conducted individually. On the other hand, they won’t necessarily produce accurate images in HPT patients who have a PTH level of 100 pg/dL or less.
4. 4D Parathyroid CT Scan
A 4D parathyroid CT scan is a relatively new option to locate an abnormal parathyroid gland. To date, it represents the most-accurate localization study available.
4D parathyroid CT scans display highly accurate images of the parathyroid anatomy. These scans are generally recommended for HPT patients who previously underwent surgery but continue to display symptoms. They can help identify the location of a defective parathyroid gland in HPT patients who previously underwent an ultrasound that delivered negative results or have PTH levels of 100 pg/dL or less.
If an Abnormal Parathyroid Gland Is Identified and Surgery Is Recommended, What Happens Next?
Parathyroid gland surgery is safe and effective, particularly when it is performed by an expert surgeon. Therefore, if parathyroid surgery is necessary, it is paramount to find an expert surgeon to perform the procedure. It ensures an HPT patient can minimize risk and achieve their desired results.
During surgery, an HPT patient receives a small incision in the neck. The surgeon removes any abnormal parathyroid glands, with little to no disturbance to any surrounding organs and structures.
What Happens After Parathyroid Gland Surgery?
Following surgery, a 4 gland assessment is performed. The assessment verifies the surgery was successful and ensures a patient won’t have to worry about long-term complications.
Will Parathyroid Glad Surgery Deliver Long-Lasting Results?
On average, the cure rates associated with parathyroid gland surgery range from 93-95%. Comparatively, Dr. Larian delivers a cure rate of 97% by performing minimally invasive parathyroidectomy surgery for HPT patients. Dr. Larian also takes steps to minimize scarring and other side effects after parathyroid surgery.
Is Parathyroid Surgery Necessary? Meet with Dr. Larian to Find Out
Dr. Larian is available to evaluate HPT patients and find out if they can benefit from surgery or other treatment options. To learn more about parathyroid gland surgery or to schedule a free phone or video consultation with Dr. Larian, please contact us online or call us today at 310-461-0300.
