Surgery catalogue head, neck
30.06.2011 | PDF | 7.79 KB
The parathyroid glands (of these usually 4 exist) are positioned left and right to the thyroid gland. They take care for optimal calcium metabolism in blood by the production of the so called parathormone. In overfunction (frequently seen in dialysis patients) the enlarge and resolve calcium from the bones which can cause osteoporosis and osteomalazia with pain and frequent fractures.
In „primary hyperparathyroidism“ there is only enlargement of one of the four parathyroid glands. It is therefore enough to remove this one gland alone and leave the normal ones in place.
In „secondary hyperparathyroidism“ there is initially a low calciumlvele in blood due to reduced uptake of calcium from the gut (mostly caused by impaired renal function). This low calcium level is partially normalized by increase in size and function of mostly all four parathyroid glands. However, this calcium is mostly mobilized from the bones by the action of parathormone. For this reason 3 and a half of the four parathyroid glands have to be removed. Simultaneously, the body has to be supplied with enough calcium from the intestinal tract which is usually being realized by administration of vitamin D and calcium supplementation in the food.
Therefore an operation can alleviate the symptoms of overfunction especially bone alterations, but also gastric ulcers and kidney stones.