Parathyroid Surgery

Primary hyperparathyroidism is most often caused by a single parathyroid adenoma. Surgery cures the disease in the great majority of patients.

Short Answer

When imaging localises a single adenoma, minimally invasive (focused) parathyroidectomy is offered. When localisation is unclear or disease is multiglandular, bilateral exploration is performed.

Confirming the Diagnosis

Persistently high calcium with high or inappropriately normal PTH, after excluding other causes, is the basis. Bone density and 24-hour urine calcium often complete the assessment.

Localisation Studies

Neck ultrasound and a sestamibi scan are the usual localisation tools. 4D-CT is added in selected cases.

Symptoms

  • Fatigue, low mood
  • Bone pain, reduced bone density
  • Kidney stones
  • Recurrent peptic complaints
  • Polyuria, polydipsia

Diagnosis and Assessment

  • Calcium, PTH, vitamin D
  • 24-hour urine calcium
  • Neck ultrasound
  • Sestamibi scan
  • Bone density (DEXA)

Treatment Options

  • Targeted (minimally invasive) parathyroidectomy
  • Bilateral neck exploration when needed
  • Intraoperative PTH monitoring in selected cases

When Is Surgery Considered?

  • Symptomatic primary hyperparathyroidism
  • Significant hypercalcaemia
  • Kidney stones or reduced bone density
  • Young patients with biochemical disease

Surgical Methods

  • Focused parathyroidectomy for a localised single adenoma
  • Bilateral exploration when localisation is unclear or disease is multiglandular

Preoperative Preparation

  • Vitamin D optimisation
  • Imaging review
  • Anaesthesia consult

Postoperative Follow-up

  • Calcium and vitamin D for a short period
  • Repeat calcium and PTH at follow-up
  • Wound care

Risks and Safe Surgery

  • Voice change (uncommon)
  • Persistent or recurrent disease
  • Bleeding
  • Wound infection

Process in Antalya

Calcium, PTH and imaging are reviewed together; if localisation is clear, focused surgery is planned, otherwise bilateral exploration is offered.

When to Seek Urgent Care

  • Severe muscle cramps and numbness (low calcium)
  • Acute neck swelling

Frequently Asked Questions

A focused operation is typically short with a small incision; bilateral exploration is a longer but still well-tolerated procedure.

Related Pages

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This information is provided for general patient education only and does not replace diagnosis, treatment or a surgical decision. Personal evaluation requires a clinical examination and the necessary tests.

Last updated: 27 June 2026 · Medical content review: Op.Dr.Gökhan ATEŞ

Thyroid & Goiter Surgery Antalya · Özel Antalya Medicalpark Hospital