There are normally four parathyroid glands, two behind the right thyroid lobe and two behind the left thyroid lobe. Its dimensions are millimetric (2-5 mm) and its color is yellow-reddish brown, which is unlikely to be distinguished by an untrained eye from the adjacent thyroid tissue. Their numbers may very rarely be congenitally high, and their locations may sometimes be outside their normal locations (such as in the rib cage, within the thymus gland, within the sheath of the carotid artery or in the thyroid tissue). In such a patient, if a condition requiring surgery for the parathyroid glands develops, it may be very difficult to determine the location of the diseased gland before and during the surgery. Additional tests may be required. In such a patient, the experience of both the endocrinology, radiology and nuclear medicine team that evaluates the patient before surgery and the surgeon who performs the surgery are very important.
The function of the parathyroid glands is to maintain calcium and phosphorus balance in the body. In this balancing act, in which vitamin D also plays an active role, parathormone dissolves calcium from the bones, which acts as a calcium store, and raises it in the blood in case of insufficient calcium intake by mouth.
Hyperparathyroidism: Excess of one or all of the parathyroid glands. It is a condition in which excessive parathormone is secreted into the blood. The most common cause is the development of a benign tumor called adenoma in one of the parathyroid glands and causing excessive parathyroid hormone secretion. In this case, blood calcium increases abnormally to the point of harming the body and osteoporosis occurs in the bones. The person feels tired and weak, bone pain, tumor development in the bone (Brown tumor) and even pathological fractures may occur in long-term cases. Kidney stones and stone-related disorders develop. The person is prone to depression. Drinking too much water, urinating a lot and constipation may occur. Treatment of parathyroid adenomas is to identify the gland in which the adenoma has developed and to remove it surgically. The most commonly used methods for detecting adenoma are ultrasonography and sestamibi scintigraphy. If the diseased gland cannot be identified, neck tomography and mediastinal tomography are performed to investigate an adenoma that develops from a parathyroid gland that is congenitally located in an abnormal location.
In renal failure, all parathyroid glands are detected. Secondary hyperparathyroidism may develop as a result of sudden operation of the brain. In this case, a surgery called 3.5 parathyroidectomy is performed to remove all three glands and leave only half of the parathyroid gland in the body. Another option is to remove all 4 glands and transplant half of one into the muscle.
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