Everyone who needs surgery wants to know all the possible outcomes. You may have spoken with your doctor, and you already have some idea of what to expect from your parathyroidectomy. However, it is common for individuals to listen to horror stories or Google scenarios. What is important to note is that “worst case scenarios” are also “rare.” Below are some scenarios that you may have read about and will hopefully put your mind at ease.
The thyroid is affected (<1%)
In extremely rare instances, the abnormal parathyroid may have grown into the thyroid, or the surgeon discovers that there is a lump in the thyroid during parathyroid surgery. If this happens, most likely half the thyroid will have to come out.
The laryngeal nerve is weakened (1%)
The laryngeal nerve is very close to the parathyroids. If it is damaged, the vocal cords could become at worst, paralysed. If not paralysed, they could still be weakened. You will probably experience trouble swallowing. Breathing problems could occur. A tumour could also be discovered attached to the laryngeal nerve.
Other parathyroid glands are involved (<1%)
Usually, only one parathyroid needs to be removed, and you probably have three of spares. The fact is, you really only need one parathyroid to enjoy normal function. However, if during the process of removing the abnormal gland, the others become non-functional, you may require calcium supplements.
Haematoma or Bleeding (<1%)
You’ve seen the medical shows on TV, in living colour, all that red… Sometimes, surgeries result in excessive blood loss. Again, this is very rare with surgeries of this type, but if you’re worried, you should know that there’s generally a good supply of blood on hand for just such eventualities. If you have a rare blood type, you could arrange to have some of your own blood collected before the operation, just in case. Or, if you’re squeamish about using “strange blood,” have a friend with the same blood type as yours make a donation. Surgeons can make the appropriate arrangements for patients who might want to be prepared for a transfusion.
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. Bleeding is a rare complication with parathyroid surgery. Accordingly the need for a blood transfusion after parathyroid surgery is rare.
Wound healing problems (<1%)
You might experience slow healing (resulting in the need for longer hospitalization), prolonged pain, scar formation, permanent numbness in the neck area, or all of the above. There could also be difficulty with healing, and the pain could continue for longer than normal.
Recurrence of hyperparathyroidism (3-5%)
There is a chance that hyperparathyroidism may return after parathyroid surgery because another tumour could develop.
More surgery is needed (1%)
If the surgeon cannot identify the gland that has the abnormality, or if they find other abnormal glands or problem glands are identified in other areas, you may need full exploratory surgery of the neck and even chest.
All these problems have been reported
The above examples have all been written about in medical journals. But you should know that parathyroid surgery is one of the safest, simplest procedures you can have. Think about this: No one ever submits an article to a medical journal that reads, “Did a parathyroidectomy today, one of a thousand or so I’ve performed, patient did fine.” These are all extreme, noteworthy occurrences that are highly unlikely to happen to you.
If you have questions about the risks and complications of parathyroidectomy be sure to discuss them with your thyroid surgeon.