Abnormally overactive parathyroid function is caused by enlargement and overactivity of one or more of the four parathyroid glands.
Usually the problem lies with the parathyroid glands themselves- Primary Hyperparathyroidism.
The commonest abnormality is a benign tumour or Parathyroid adenoma, on one of the glands. Less commonly, there can be two or more adenomas, generalised enlargement of all glands- which is called parathyroid hyperplasia, or rarely parathyroid cancer.
If there is a stimulus ( such as kidney failure or low Vitamin D) which is the cause of the parathyroid overactivity, we call this secondary hyperparathyroidism- which is an altogether different problem.
Re-operation for Primary hyperparathyroidism
In nearly all cases, despite initial failure to cure at the first or subsequent operation, it will still be possible to operate and cure you, without complications.
If you have had a single adenoma removed, re-operation in expert hands is usually fairly straightforward. With a combination of well performed imaging and expert surgical care, the remaining abnormal glands can be found and removed, despite the scar tissue, leaving sufficient parathyroid function in nearly all cases. Sometimes transplantation of a small piece of your abnormal parathyroid tissue into a muscle in your neck will be performed, when there is a risk that you would be left with no parathyroid function otherwise.
Risk of voice damage and bleeding remains very low, but is significantly higher than for initial surgery.
