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What are the risks associated with parathyroid surgery?

Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
Local discomfort, bruising and all the usual complications of anesthesia are risks of parathyroid surgery.  However, the main serious complications specific to parathyroid surgery are two: 
 
1.  Hypoparathyroidism.  This occurs if all of the parathyroid tissue is damaged or removed.  This is never the intent, but it can occur if the hyperparathyroidism is the result of multiple gland hyperplasia and the surgeon has to remove at least 3 of the 4 glands, or even 3 glands fully and a portion of the fourth gland.  It can also occur if the overactive parathyroid gland is difficult to find, in which case there may be damage to all the glands during surgery.  The parathyroid glands are small and may be difficult to find in the neck.  Even an overactive parathyroid gland--termed a parathyroid adenoma and representing a benign tumor--may be relatively small and hard to locate.  In addition, the glands are sometimes located in unusual places such as in the chest. 
 
2.  Damage to the recurrent laryngeal nerves which control the vocal cords.  This can happen because the nerves are close by the thyroid and parathyroid glands and may be difficult to avoid while doing surgery. 
 
Both of the problems are relatively uncommon, and most of the time they are both temporary.  These problems can also occur with thyroid surgery, because the parathyroid glands and the thyroid gland are situated close together in the neck. 
 
The problems can be reduced in frequency by localizing the overactive parathyroid gland prior to surgery by a nuclear medicine test called a parathyroid Sestamibi or by ultrasound of the neck.  A highly experienced surgeon will also have a much lower frequency of these complications, so it's important to seek out a surgeon who does enough parathyroid and thyroid surgery to have good outcomes. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.