Parathyroidectomy - Complications

Did you experience complications with your parathyroidectomy?

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What are the possible complications of parathyroidectomy?

The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. They are listed here for your information only, not to frighten you, but to make you aware and more knowledgeable concerning parathyroidectomy. Although many of these complications are rare, all have occurred at one time or another in the hands of experienced surgeons practicing community standards of care. Anyone who is contemplating surgery must weigh the potential risks and complications against the potential benefits of the surgery or any alternative to surgery.

  1. Damage to the recurrent laryngeal nerve with resultant weakness or paralysis of the vocal cord or cords: This is a rare but serious complication. Unilateral weakness results in a weak, breathy voice, and there will be problems swallowing. A second surgical procedure can alleviate many of the symptoms of unilateral vocal cord paralysis. Bilateral vocal cord paralysis results in a relative normal voice; however, there is difficulty breathing, and the patient may ultimately require a tracheotomy. Every effort is made to protect the recurrent laryngeal nerve. Temporary vocal cord weakness occurs much more frequently than permanent vocal cord weakness, and it usually will resolve after several days or within a few weeks. Rarely, a malignant tumor has already invaded the nerve and has caused vocal cord weakness or paralysis.
  2. Bleeding or hematoma: In rare situations, a blood transfusion may be necessary because blood is lost during surgery. Patients can choose to have autologous blood (their own blood) or blood from a friend or relative collected in advance of the surgery in case a transfusion is necessary. The surgeon can make arrangements for patients interested in these options.
  3. Damage to the remaining parathyroid glands with resultant problems in maintaining calcium levels in the blood: In most situations, you only need one functioning gland to have normal calcium levels. In the rare event that all glands are removed, blood calcium levels may fall, and patients may need to take calcium supplementation for the rest of their lives.
  4. Need for further and more aggressive surgery: In some cases, surgical exploration fails to identify the abnormal parathyroid gland or multiple abnormal glands may be present. Further and more aggressive surgery may be necessary, such as an extensive surgical exploration of the neck or chest.
  5. Need for a limited or total thyroidectomy: In rare situations, the abnormal parathyroid gland is within the thyroid gland itself or an unexpected thyroid carcinoma, a malignant cancer, is identified. In such situations, much or all of the thyroid gland must be removed, and there may be a need for life-long thyroid hormone treatment.
  6. Prolonged pain, impaired healing, need for prolonged hospitalization, permanent numbness of the neck skin, poor cosmetic result, and/or scar formation.
  7. Recurrence of the tumor or failure to cure the tumor despite effective therapy.
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