OVERVIEW

Parathyroid conditions encompass various disorders or irregularities that impact the parathyroid glands, four small glands situated behind the thyroid gland in the neck. These glands assume the crucial function of producing and controlling the parathyroid hormone (PTH), which plays a vital role in preserving appropriate calcium levels within the body. Parathyroid conditions prompt high blood calcium levels causing weak bones, tiredness and kidney stones. Dr Botes treats the following parathyroid conditions:

• Primary hyperparathyroidism occurs when one or more of the parathyroid glands become overactive and produce excessive amounts of PTH. The most common cause is a benign tumour known as a parathyroid adenoma.
• Secondary hyperparathyroidism is usually a result of another underlying condition, such as chronic kidney disease, which leads to increased PTH production. The primary treatment for secondary hyperparathyroidism involves managing the underlying cause. However, in some cases, surgical intervention may be necessary.
• Tertiary hyperparathyroidism typically occurs in individuals with long-standing secondary hyperparathyroidism, where the parathyroid glands become autonomous and continue to produce excessive PTH even after the underlying cause is resolved.
• Parathyroid cancer is a rare condition where one or more of the parathyroid glands develop malignant tumours.

TREATMENT

Parathyroidectomy is a surgical procedure performed to remove one or more parathyroid glands or tumours. Parathyroidectomy can be performed through traditional open surgery or minimally invasive techniques. In open surgery, an incision is made in the neck to access and remove the affected glands. Minimally invasive approaches include techniques like minimally invasive radio-guided parathyroidectomy (MIRP), video-assisted parathyroidectomy (VAP), minimally invasive direct parathyroidectomy (MIDP), and robotic-assisted parathyroidectomy. These methods offer advantages such as smaller incisions, reduced scarring, and faster recovery. The choice of approach depends on the individual patient's condition and the surgeon's expertise.

Overall, parathyroidectomy is an effective treatment for various parathyroid conditions. The specific surgical technique used will depend on factors such as the number and location of the affected glands, the surgeon's preference, and the patient's overall health. Whether performed through open surgery or minimally invasive methods, the goal of parathyroidectomy is to remove the abnormal glands or tumours and restore normal parathyroid function, thereby alleviating the symptoms associated with excessive PTH production.