Consultant ENT Surgeon
Parathyroid disease (Hyperparathyroidism)
Parathyroid disease (Hyperparathyroidism)
Parathyroid glands are tiny endocrine glands located at the front of the neck around the thyroid gland and are approximately the size of a grain of rice. Their job is to synthesise a hormone, parathyroid hormone. This is critical for regulating the calcium levels within the blood and regulates influences calcium absorption, the bones, kidneys, and from the gut.
The location of Parathyroid glands can be quite variable within the neck but often they are closely associated with with the posterior aspect of the thyroid gland and most patients have four glands although there can be fewer or significant more numerous glands on occasion
Condition
Hyperparathyroidism is a relatively common condition whereby one or more of the parathyroid glands starts to secrete excessive parathyroid hormone. The effect of this is to raise the calcium level in the blood by removing calcium gradually from the bone reserves in the body. Patients with hyperparathyroidism can be entirely asymptomatic, but some patients feel tired, low in mood, notice a dry mouth or have generalised aches and pains. hyperparathyroidism and the resulting high calcium level can cause long-term health issues affecting bone density leading to osteoporosis. It may also have detrimental effects on long-term kidney function.
Surgery has a very high percentage of cure of 95% or upwards. Complication rates from parathyroid surgery are rare but a very small proportion of patients will have a weak, breathy voice after surgery related to damage to the nerves around the voice box. This happens in significantly less than 1% of operations under Mr Howe’s care.
There is a approximately 3% lifetime risk of one of the remaining para heart glands becoming overactive in future. Mr Howe recommends that patients consider long-term vitamin D supplementation afterwards after surgery to maintain a vitamin D in the normal range. Mr Howe has been undertaking substantial volumes of parathyroid surgery since starting as a consultant in 2010 and has a particular interest in revision parathyroid surgery.
Mr Howe’s practice is to use intraoperative parathyroid hormone testing for all patients undergoing surgery. This rapid and effective assay using the NBCL system gives a high indication of curative Surgery at the time of operating. It reduces the risk and need for further dissection of the soft tissues of the neck after the hyperfunctioning gland has been removed.
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