Parathyroid Disorders and Surgery in Gurnee, IL and Surrounding Areas

Dr. Angelique Cohen practices the full specialty of Otolaryngology- Head and Neck Surgery in Libertyville, IL, serving the Lake County area and Northern Suburbs of Illinois, and treats adult and pediatric patients. However, she has a special interest in endocrine head and neck surgery, which includes the surgical treatment for diseases of the thyroid and parathyroid glands. Her experience allows for use of the standard historical surgical approach intertwined with advanced modalities in achieving excellent outcomes for her patients.

Parathyroid glands rest along our thyroid gland in the lower neck. There are typically 4 glands, 2 on each side, although there can be a 5th gland or additional ectopic parathyroid tissue. The purpose of these glands is to secrete parathyroid hormone. Parathyroid hormone helps to regulate metabolism of calcium and phosphorous in our body. Enlargement of one or more of the parathyroid glands can cause overproduction of parathyroid hormone which can lead to elevated calcium levels in the blood and bone loss (osteoporosis). The excess parathyroid hormone causes release of calcium into the blood stream which then is filtered through the kidneys and can also lead to kidney stones (nephrolithiasis). Although some medicnes can be used to decrease the calcium levels and to help bone loss, there is no current medical cure for hyperparathyroidism, other than surgery. This surgery is called a parathyroidectomy. The goal of parathyroid surgery is to remove the offending parathyroid glands. Hyperparathyroidism may be caused by enlargement of one parathyroid gland (a parathyroid adenoma) or multiple glands (hyperplasia or multiple adenoma). Typically about 85% of hyperparathyroidism is due to disease of a single gland. 15% are due to multiple gland disease. The goal of surgery is to preserve the good glands and remove the hyperfunctioning glands. 

The glands are evaluated preoperatively by imaging, in an effort to determine if one or more glands are involved and to help determine the approximate location of those glands. The parathyroid glands can hide anywhere from the hyoid bone to the chest (mediastinum) but are most commonly neighbors to the thyroid gland. Normal sized glands are quite small, about 5mm and require meticulous dissection to identify and preserve. Imaging that may be useful in localization of the offensive glands include ultrasound and a parathyroid scan most commonly. Other modalities sometimes used would be a CT scan, MRI scan or SPECT/CT. Intraoperatively dissection can be guided by the use of gamma probe, which may be used. Most useful has been the employment of intraoperative PTH level testing. This allows chemical identification of an appropriate drop in parathyroid levels while operating after removal of the enlarged parathyroid gland(s).