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Thyroid glands play an important role in the health of our body. They are located right next to the thyroid gland, and their main role is to regulate calcium levels in the body.
Problems with the thyroid gland can occur in the form of bone disorders, kidney stones, cardiovascular complications or, in the worst case, tumors.
Along with hormone replacement therapy, thyroid surgery is considered the optimal solution for treating any problems of the same. The procedure is quick and minimally invasive.
The parathyroid glands are small glands that are located right next to the thyroid gland. There are usually four of them, two on each lobe of the thyroid gland. In rarer cases, there are more, but rarely more than six.
With vitamin D, the parathyroid glands are required to maintain the normal function of calcium in the blood. They do this by releasing parathyroid hormone (PTH) directly into the bloodstream.
The secretion of parathyroid hormone occurs inversely proportional to the amount of calcium in the blood. In other words, if PTH in the blood is elevated, it indicates a lack of calcium. Likewise, a reduced amount of calcium stimulates the secretion of hormones.
The way PTH works is very effective; If there is less calcium in the blood, parathyroid hormone “pulls” calcium and phosphate from bone structures, increases the absorption of calcium from the intestine and the excretion of phosphate by the kidneys.
If there is too much calcium, the thyroid gland reduces the production of PTH and thus calcium is stored in bone tissue, intestines and other organs.
To put it simply, if the body needs more calcium in the blood, the thyroid gland will secrete more parathyroid hormone, and if it needs less calcium, it will secrete less parathyroid hormone.
The main disorders arise precisely in the excessive or insufficient release of parathyroid hormone into the blood.
When there is an increased release of parathyroid hormone, a disorder called hyperparathyroidism occurs.
The opposite disorder is called hypoparathyroidism, and it occurs as a result of thyroid surgery, an autoimmune disease, or radiation. PTH deficiency results in reduced calcium production and as a consequence there are problems with muscle and nerve cells.
Surgery of the thyroid gland is the best solution for the treatment of hyperparathyroidism. By removing the thyroid gland, the production of parathyroid hormone decreases and the amount of calcium in the blood is returned to normal.
In the case of hypoparathyroidism, hormone replacement therapy and consumption of calcium and vitamin D will be sufficient.
The secretion of parathyroid hormone does not necessarily have to be the same in all four glands. If increased PTH secretion occurs in only one gland, hyperplasia or adenoma of the parathyroid gland is suspected, and surgical removal of tissue is the best solution in this case.
Increased production of PTH causes hypercalcemia, an increased amount of calcium in the blood. If you notice the following symptoms, it is most likely some kind of disorder of the parathyroid gland:
These disorders occur because the increased secretion of parathyroid hormone causes calcium to be absorbed from your bones, which can lead to their reduced density and the deposition of stones in the kidneys.
Surgery is a permanent solution in the treatment of hyperparathyroidism, and at the Lohuis Filipović Polyclinic we do everything to successfully treat disorders of the parathyroid gland.
In order to give an adequate diagnosis, several tests need to be performed before the operation.
Some of these methods include thyroid scintigraphy and sometimes ultrasound, blood tests, filling out forms and consultations for other problems.
Scintigraphy is one of the diagnostic methods by which the movement of radioactive substances in the body can be recognized. Similar to radioactive iodine, the liquid Tc-99m pertechnetate is introduced through your veins, and after 20 minutes, the desired area is observed.
The examination is similar to ultrasound, only the goal is to show those substances that are affected by radioisotopes. Thus, the gamma camera records the anatomy and function of the thyroid gland and surrounding tissues such as the parathyroid glands.
Ultrasound is used to show the size, location and structure of the thyroid gland and surrounding tissues, which gives us a detailed insight that later serves us for the plan and method of surgery.
In addition to ultrasound and scintigraphy, we will need a blood count through which we can see the amount of hormones released such as thyroid hormones (T3, T4 and TSH) and thyroid hormones (PTH) as well as the amount of calcium in the blood.
Since thyroid surgery must be performed under general or local anesthesia, depending on the size of the tissue to be removed, you will need to fill out a form to give your consent to its use.
If you have allergies to anesthesia, or to other materials such as latex, be sure to inform us about it. In such circumstances, we may have to postpone the operation or find another solution.
In case you suffer from a blood clotting disorder, or if someone in your family is experiencing similar problems, please let us know so that we can adapt and choose the appropriate method of the procedure.
Also, a few days before the operation, do not consume blood-thinning tablets: Aspirin, Ibuprofen, Andol, Naproxen…
10 hours before the procedure, avoid consuming food, and be sure to come to the operation with an escort.
Namely, in the case of general anesthesia, the feeling of weakness and dizziness may be present several hours after waking up. Therefore, driving after surgery is not recommended.
Surgery of the thyroid gland
The surgery is performed through the same incision in the neck as for thyroid surgery. The surgeon then purposefully (according to the previously performed scintigraphy findings) finds an enlarged and intensely active parathyroid gland behind located next to the thyroid lobe and extirpates it, i.e. It is removed from the thyroid gland and removed from the neck. In doing so, care is taken not to damage the recurrent laryngeal nerve, which is responsible for the movement of the vocal cords.
After the operation, the level of PTH and calcium in the blood must be checked, and these values are compared with the preoperative ones.
After surgery , you may need to spend the night in a polyclinic. You can return to daily activities two to three weeks after surgery, and until then, do not overdo it with physical activity.
You will be invited to a few more check-ups in the next six months, to check the amount of calcium and PTH in your blood.
You may need to take replacement therapy with supplements such as vitamin D and calcium due to lower calcium secretion.
If the surgery is done correctly, complications are rare. However, as rare as they are, you may experience side effects typical of parathyroid surgery:
It occurs as a result of injury, swelling or stretching of the return nerve located next to the thyroid gland and parathyroid gland. They can cause hoarseness and shortness of breath, and the injury usually goes away after a few weeks.
This phenomenon is also called hypocalcemia, and it is treated with vitamin D supplements and calcium injections.
If only one or two glands have been removed, replacement therapy will not be used for a long time. However, in the case of removal of all glands, lifelong therapy is required.
In rare cases, there is a possibility that even after the removal of the enlarged parathyroid gland, a disorder such as hypercalcemia and hyperparathyroidism remains.
In addition to the risks specific to thyroid surgery, standard side effects can occur, such as bleeding, infections, or the risk of an allergic reaction to anesthesia.
At the Lohuis Filipović Polyclinic , we perform thyroid gland surgery on a regular basis; Our team of specialists in neck and head surgery will make sure that the procedure is performed successfully, with the possibility of speedy recovery and as few complications as possible.
Make an appointment today; Call us at +3851 2444 646 or fill out our online form.
The main goal of LF Polyclinic is to improve the quality of life and health of our clients by providing them with top-notch healthcare services.
