ارتباط غدد پاراتیروئید با غده تیروئید

غدد پاراتیروئید، چهار غده کوچک هستند که در پشت غده بزرگ تیروئید قرار دارند. The main function of the parathyroid glands is to maintain the normal level of calcium in the blood. This is done through the production of parathyroid hormone (PTH). Parathyroid and thyroid have completely different functions. Parathyroid glands control the level of calcium in the blood, and the thyroid is responsible for regulating the body's metabolism. However, due to their anatomical proximity, any damage to the thyroid gland during thyroid surgery may also damage the parathyroid glands. These damages can be temporary or permanent.

Changes Parathyroid after thyroid surgery

The main complication that parathyroid glands face after thyroid surgery is hypoparathyroidism or hypoparathyroidism. During thyroid surgery, the parathyroid glands may become compromised due to physical injury, decreased blood flow, or inadvertent removal. Therefore, the production of parathyroid hormone (PTH) decreases, which leads to a decrease in the level of calcium in the blood. This medical condition is called hypoparathyroidism. According to the severity of the effect of thyroid surgery on the parathyroid, the resulting changes can be temporary or permanent:

Temporary hypoparathyroidism:

Temporary parathyroid hypofunction is the most common complication after thyroid surgery, which is seen in about 5% of patients. This condition occurs due to trauma or minor damage to the parathyroid glands during surgery. In this situation, the functioning of the glands is temporarily disrupted and they go into so-called shock. This condition usually lasts a few weeks to a few months (usually 6 months) and is easily managed. Taking calcium and vitamin D supplements has an effective role in improving temporary hypoparathyroidism. Gradually, with the return of the normal function of these glands, the symptoms disappear and the need to take medicine is removed.

Permanent hypoparathyroidism:

A rare and more serious complication that can occur after thyroid surgery is permanent hypoparathyroidism. This condition occurs when the parathyroid glands are severely damaged or completely removed during surgery. In permanent hypoparathyroidism, the body loses the ability to produce PTH hormone and blood calcium levels are chronically low. Therefore, the patient has to use calcium and vitamin D supplements for the rest of his life. This lifelong treatment helps control calcium levels and prevent more serious complications such as seizures, heart problems, osteoporosis, etc.

Symptoms of parathyroid changes appear immediately after thyroid surgery or a few days later. The severity of these symptoms varies according to the extent of parathyroid damage and the level of calcium depletion. The most common symptoms of parathyroid problems after thyroid surgery include the following:

• Numbness and tingling around the mouth, lips and fingertips
• painful muscle cramps especially in hands, feet and face
• Extreme fatigue, muscle weakness and decreased energy during the day due to low calcium levels
• Anxiety, irritability or depression

The above are the usual and initial symptoms of calcium deficiency caused by parathyroid hypofunction. If these symptoms are ignored and the calcium loss worsens, the body will face much more serious complications; Including:

• Shortness of breath and difficulty in swallowing due to severe spasm of the larynx and respiratory tract
• uncontrollable stiffness and contraction of muscles (tetany) with inward bending of wrists and fingers
• Seizures
• Heart problems such as irregular heartbeat and heart failure
• Long-term neurological and psychological effects such as severe anxiety and memory impairment

The experience and skill of the thyroid surgeon plays a significant role in maintaining the health of the parathyroid glands. Knowing the sensitive and complex anatomy of the neck is the most important thing to reduce the risk of parathyroid hypofunction and its complications after surgery. An up-to-date thyroid surgeon who is well-versed in modern technologies protects these small glands well during the operation by identifying and preserving the blood vessels feeding the parathyroid glands. The use of modern tools such as nerve monitoring helps to accurately identify the parathyroid and take care of sensitive nerves in the surgical areas and minimizes the risk of parathyroid hypofunction.

Dr. Seyed Ahmed Fanai, Thyroid and parathyroid surgeon, with more than 20 years of experience in general surgery and 15 years of specialized experience in this field, is considered one of the leading specialists in the field of thyroid diseases. He is an associate professor of general surgery and an active member of the American Thyroid Association (ATA), and he keeps his knowledge up-to-date by participating in its annual congresses. Having performed more than 5000 successful thyroid surgeries, Dr. Fanai is well familiar with the sensitivity of this procedure. Considering the vital importance of the laryngeal nerves and the protection of the parathyroid glands in these surgeries, they minimize the complications of surgery by using modern devices such as intraoperative neurometry and taking advantage of their high experience and skill.

End

Parathyroid glands, due to their anatomical proximity to the thyroid gland, usually undergo changes after thyroid surgery, the most common of which is hypothyroidism. This problem is associated with symptoms such as tingling and muscle spasms and is easily controlled in most cases. Although thyroid surgery can cause changes in the function of the parathyroid glands; But choosing an experienced thyroid surgeon minimizes the possibility of these complications and plays a role in effective and quick treatment of temporary complications.