Dr Karthik K Prasad

MINISCULE BUT MIGHTY

Parathyroid glands are two pairs of small glands, located close to the thyroid gland in the neck. The parathyroid gland produces and secretes parathormone which plays a key role in regulation of the calcium levels in the blood.

Parathyroid glands removal leads to low calcium levels in the blood. Most often it is inadvertently removed during thyroidectomy due to its close proximity and also difficulty in identifying the gland. Most of the thyroid gland pathology does not have any abnormality in the parathyroid glands.

Thyroidectomy is one of the most common surgeries with low complications which is related to the skill and expertise of the surgeon. Hypocalcemia or low calcium is the most common but critical complication following thyroidectomy which requires urgent treatment. Symtoms of hypocalcemia commonly include paresthesia, circumoral numbness, muscle spasms, tetany and seizures.

Hypocalcemia is usually seen within 24 – 48 hrs after surgery. Incidence of hypocalcemia may be as high as 25-40% and is more common in total thyroidectomy and female patients. Injury to the parathyroid gland or devascularisation is the known etiology.

Calcium supplementation is the cornerstone in the treatment. Early recognition of symptoms and prompt treatment decrease the morbidity and hospital stay.

We often look at the thyroid pathology and fail to identify what is in the background i e parathyroid glands. Sometimes what is in the background turns out to be equally or more important than what we are actually looking at.

by Thomas | Feb 28, 2010 | Animals, Endangered Species, India, Kaziranga

The parathyroid glands were first discovered

in the Indian Rhinoceros.

Simple orderly steps can prevent post thyroidectomy hypocalcemia.

First and the foremost proper evaluation of the parathyroid glands and its function before surgery.

Second, it is critically important for surgeons to identify and preserve the parathyroid glands – structurally and functionally by slow and meticulous dissection during surgery.

Finally the early calcium supplementation following thyroidectomy till the parathyroid glands gradually regain its full function.

Small glands if fail to look after result in the complications which will be mightier. We at BGS Gleneagles global hospital aim at curative surgery with minimal complications.