Minimally Invasive Parathyroid Surgery
Parathyroid Glands
The Parathyroid Glands are small glands located in the neck, behind the Thyroid Gland. There are usually four Parathyroid Glands, two on each side of the neck; each gland is normally about the size of a grain of rice. The Parathyroid Glands produce Parathyroid Hormone, which helps to regulate and maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning. It is important to note that although the Thyroid and Parathyroid Glands are located next to one another and share similar names, they serve very different functions.
Hyperparathyroidism
Hyperthyroidism is the most common disease of the Parathyroid Glands. Hyperparathyroidism is the overproduction of the Parathyroid Hormone by one or more of the glands. Hyperparathyroidism results in high levels of calcium in the blood (Hypercalcemia).
Primary Hyperparathyroidism
Hyperparathyroidism is commonly caused by a Parathyroid Adenoma or enlargement of all of the Parathyroid Glands (Primary Hyperparathyroidism). Primary Hyperparathyroidism usually occurs randomly, but some people inherit a gene that causes the disorder. The most effective treatment of Primary Hyperparathyroidism is surgical removal of the malfunctioning Parathyroid Gland(s). Causes of Primary Hyperparathyroidism include:
Parathyroid Adenoma
Parathyroid Adenoma is a non-cancerous tumor of the Parathyroid Glands. It is the enlargement of one Parathyroid Gland and accounts for about 90 percent of all patients with Primary Hyperparathyroidism. Multiple Parathyroid Adenomas are seen in 5-10 percent of patients with primary Hyperparathyroidism. The enlarged gland(s) produce excessive Parathyroid Hormones resulting in Hyperparathyroidism.
Parathyroid Hyperplasia
Parathyroid Hyperplasia is the growth and over-activity of all four Parathyroid Glands. It is also referred to as Four Gland Hyperplasia. Parathyroid Hyperplasia accounts for 2-5 percent of patients with Primary Hyperparathyroidism.
Parathyroid Cancer
Parathyroid Cancer is a rare cause of Primary Hyperparathyroidism. It accounts for less than 1 percent of patients with Primary Hyperparathyroidism.
Secondary Hyperparathyroidism
Hyperparathyroidism can also be a result of another disease that affects the glands' function (Secondary Hyperparathyroidism). The most common cause of Secondary Hyperparathyroidism is kidney failure. Secondary Hyperparathyroidism is usually managed by treating the underlying medical problem.
Symptoms
Most patients with Hyperparathyroidism have no symptoms. Hyperparathyroidism is often discovered accidentally when blood tests done for another medical reason reveal high calcium levels.
Symptoms that may occur include:
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Diagnostic Studies
The work up for Hyperparathyroidism is usually initiated following the diagnosis of elevated calcium levels (Hypercalcemia). If further blood tests reveal an elevated Parathyroid Hormone level, Hyperparathyroidism is diagnosed.
Once diagnosed with Hyperparathyroidism, it is important to distinguish whether the elevated Parathyroid Hormone levels are caused by Primary Hyperparathyroidism or Secondary Hyperparathyroidism. In Primary Hyperparathyroidism, enlargement of one or more Parathyroid Glands is the source of the problem. In Secondary Hyperparathyroidism, another disease process (often kidney failure) leads to elevated parathyroid hormone levels.
The most effective treatment of Primary Hyperparathyroidism is surgical removal of the malfunctioning Parathyroid Gland(s). Secondary Hyperparathyroidism is usually managed by treating the underlying medical problem.
If diagnosed with Primary Hyperparathyroidism, it is very important to identify the location of the abnormal Parathyroid Gland(s). This assists in surgical planning and reduces operative time and dissection. Usually, a combination of two imaging tests is used to locate the Parathyroid Gland(s) that is causing problems:
Parathyroid Ultrasound
A Parathyroid Ultrasound is a simple and safe method to examine the Parathyroid Glands. The Ultrasound uses sound waves to produce a picture of the Thyroid and Parathyroid Glands. The ultrasound machine uses high-frequency sound waves, rather than radiation, taken by a hand-held instrument maneuvered over the skin to develop a picture on a monitor.
A Parathyroid Ultrasound is used to help identify the presence, size, and location of parathyroid tumors. Parathyroid Ultrasonography is non-invasive, risk-free and painless.
Dr. Zadeh is committed to providing the highest quality and most efficient care possible so that his patients achieve fast and effective treatment. Therefore, at his office, he has access to the most advanced diagnostic technology available to expedite diagnosis. Dr. Zadeh performs his own Parathyroid Ultrasounds in the office at the time of the consultation.
Sestamibi Scan
Sestamibi is a specially designed radioactive compound that is absorbed by overactive Parathyroid Glands. A small dose is injected into the bloodstream and can be detected by imaging. Sestamibi Scan is the preferred method of finding the location of an abnormal parathyroid gland.
Parathyroid Surgery
Surgical removal of one or more Parathyroid Glands is called a Parathyroidectomy. Parathyroidectomy is the most common and effective treatment for Primary Hyperparathyroidism (enlargement of one or more Parathyroid Glands).
Minimally invasive Parathyroid Surgery is performed by making a small incision in the neck. Recent advances in Parathyroid Surgery allow for smaller incisions, minimal damage to surrounding tissues and much shorter recovery time.
Dr. Zadeh utilizes rapid intra-operative parathyroid hormone assays. This is a specialized blood test that is elevated in patients with Hyperparathyroidism and returns to normal within 10 minutes of removal of the abnormal Parathyroid Gland(s). Dr. Zadeh is therefore able to confirm the success of the surgery prior to the patient leaving the operating room. This minimally invasive approach significantly reduces operative time by avoiding unnecessary exploration and surgery. In addition, the risk of surgical complication is decreased and the recovery period is shortened.
Parathyroid disease can be very serious if left untreated and it is important to see a doctor promptly if you think you may be affected by a parathyroid disorder. Dr. Zadeh is committed to providing the highest quality and most efficient care possible so that his patients achieve fast and effective treatment. Dr. Zadeh implements distinctive surgical approaches using the safest, most advanced, and minimally invasive techniques. Dr. Zadeh is focused on cutting-edge techniques and treatment options that offer his patients the greatest outcomes while minimizing risk.
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To schedule an appointment with Dr. Zadeh, please contact:
Mani H. Zadeh, M.D., F.A.C.S.
2080 Century Park East
Suite 1700
Los Angeles, CA 90067
Tel: (310) 201-0717
Fax: (310) 201-9665
Email: info@ZadehMD.com
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