parathyroidectomy
Meaning of parathyroidectomy: An operation aimed at a gland most people cannot name, usually done because one of the four has grown a benign lump.
Definition of parathyroidectomy
Parathyroidectomy is surgery to remove one or more parathyroid glands, the small glands that sit behind the thyroid and control the level of calcium in the blood. It is performed most often when a single gland has become overactive and is releasing too much parathyroid hormone, which pulls calcium out of the bones and raises it in the blood.
How parathyroidectomy is built
- para- Prefix · Greek beside, near, alongside, abnormal
- thyr/o, thyroid/o Combining form · Greek thyroid gland
- -ectomy Suffix · Greek surgical removal, excision
A medical term is read from its ending backwards: the suffix first, then the prefix, then the root. See all 223 word parts.
Why would a parathyroid gland need removing?
The usual reason is primary hyperparathyroidism, a state in which one gland ignores the signal to stop. In most people a single benign growth called an adenoma is responsible, and the remaining glands are normal and quiet. Less often all four are enlarged, which happens in long standing kidney failure, when persistently low calcium drives every gland to work harder. Cancer of a parathyroid gland is rare. The consequences of the excess hormone are what prompt the operation: thinning bone, kidney stones, tiredness and, when calcium climbs far enough, confusion.
How is the overactive gland found?
This is the harder half of the problem. The glands are about the size of a grain of rice, their number varies from person to person, and they can sit anywhere from the angle of the jaw down into the chest. Imaging beforehand, usually a nuclear medicine scan combined with ultrasound of the neck, points the surgeon toward one side. During the operation the level of parathyroid hormone in the blood can be measured directly, and a sharp fall within minutes of removing the suspect gland confirms that the source is gone. When localization fails, both sides of the neck are explored and every gland identified.
How does it differ from thyroid surgery?
| Feature | Parathyroidectomy | Thyroidectomy |
|---|---|---|
| Target | One to four rice-sized glands | The butterfly-shaped thyroid |
| Usual reason | Too much calcium in the blood | Nodules, goiter or cancer |
| Hormone replacement after | Rarely needed | Routine when the whole gland is taken |
The incision looks the same and the two operations share their main risks, because the nerve to the voice box and the parathyroid glands themselves lie in the same narrow space. Hoarseness follows injury to that nerve. Calcium can fall sharply in the days afterward, either because the remaining glands have been suppressed by years of high hormone levels or because hungry bone soaks up mineral once the excess hormone stops.
Also known as
Used in a sentence
A focused parathyroidectomy was performed after imaging localized a single adenoma.
Good to know
Blood calcium can fall sharply in the days after the operation, because the remaining glands have been suppressed by prolonged high hormone levels and because bone takes up mineral rapidly once the excess stops.
Word origin
Where “parathyroidectomy” comes from
Parathyroid joins the Greek para, meaning beside, with thyreos, a door shaped shield that named the neighboring thyroid gland; -ectomy comes from ektome, a cutting out.