A parathyroid adenoma is a benign tumor that impairs calcium metabolism due to increased production of a parathyroid hormone. It is this adenoma that causes 90% of all cases of hyperparathyroidism. The disease most often develops in people between the ages of 50 and 70 years old. The disease affects women three times more often than men. In Germany, parathyroid adenomas are successfully treated with minimally invasive surgery.
The disease is treated surgically, most often it is a minimally invasive operation. After the adenoma removal surgery, the parathyroid hormone and calcium levels in the blood return to normal.
You can undergo your treatment in one of the following hospitals: Hospital Neuperlach Munich, University Hospital Ulm, or University Hospital Frankfurt am Main.
You do not have to take care of any organizational issues because the Booking Health company will fully arrange your trip. The company's specialists will recommend the most suitable clinic and doctor for you, help you to apply for a visa and get medical insurance, book airline tickets, translate medical records into German, and control the cost of procedures. You can contact your personal medical coordinator for any questions that may arise.
What is a parathyroid adenoma?
The parathyroid glands are small, oval-shaped organs located near the thyroid gland. About 85% of people have 4 glands, 2 of which are located at the top and 2 are found at the bottom of the thyroid gland. The superior parathyroid glands are usually located on the posterolateral surface of the middle and superior lobes of the thyroid gland. The location of the inferior parathyroid glands is variable. They are most often localized in the lower third of the thyroid gland.
A normal parathyroid gland is about the size of an apple seed and weighs approximately 0.5 g. Microadenomas are defined as tumors, their weight is less than 0.1 g, while giant adenomas weigh more than 2 g. The average weight of an adenoma is 1 g.
The glands secrete a parathyroid hormone, and patients with the adenoma have too much of it. This hormone plays a vital role in the metabolism of calcium and phosphorus in the kidneys, intestine, and bones. A pathological hyperproduction of parathyroid hormones causes an inadequate increase in calcium levels, with a depletion of phosphate reserves. Patients develop the following symptoms:
- bone pain;
- fatigue;
- constipation;
- neuropsychiatric disorders.
Kidney stones often form. A sharp increase in calcium levels may cause severe complications, such as arrhythmias, a coma, and even death.
Surgical treatment
The treatment of parathyroid adenoma in Germany is surgical. Doctors mobilize the thyroid gland, after which they detect and remove the enlarged parathyroid glands. It is best to be treated by an experienced surgeon to minimize the risk of lesions on the recurrent laryngeal nerves.
German doctors perform the operation using safe and minimally traumatic techniques. The parathyroid glands can be removed by a video-assisted mini-access, through an incision up to 2 cm long. Once the operation is complete, surgeons apply an intradermal cosmetic suture, which eliminates the appearance of a large scar and improves the aesthetic result of the operation.
The results of the operation are monitored using laboratory diagnostics immediately, even before its completion. Doctors check the parathyroid hormone levels. After the parathyroid gland removal, the levels should decrease by at least 50% within 10 minutes. If there is no such decrease, this indicates that the patient also has other parathyroid glands, which may be located in an unusual place.
The surgeon looks for these glands to remove them. The accessory parathyroid glands may be located in the pharynx, behind the esophagus, in the posterior mediastinum, in the thymus, within the thyroid capsule, or in the carotid sheath.
Complications
The risk of complications depends on the surgeon's experience and skills.
The most common complication during an adenoma removal is a recurrent laryngeal nerve injury. It may be unilateral or bilateral. A unilateral injury results in hoarseness, while a bilateral one causes breathing problems.
Both an intersection and stretching of the nerve can lead to its injury. It can also be compressed or thermally damaged. If the nerve is not completely intersected, but only squeezed or stretched, then the symptoms disappear after 1-1.5 months. However, if the symptoms persist for more than 6 months, the chances of nerve recovery are close to zero.
During the operation, the surgeon may notice a nerve injury and suture it together in order to ensure its follow-up regeneration.
Treatment results
Both conventional and minimally invasive operations provide patients with approximately the same risk of complications and likelihood of a cure for their parathyroid adenoma. The success of the surgical treatment is on average 95%, and in the best clinics in Germany this indicator reaches 98%. The probability of developing complications is on average 3%, and in the specialized Head and Neck Surgery Centers, it is less than 1%.
The minimally invasive approach is considered to be the preferred technique in Germany. First of all, its advantage lies in the best aesthetic outcome: there are no large scars on the neck. Other benefits include less postoperative discomfort and a faster rehabilitation.
After the treatment, the calcium levels in the patient's blood decrease and return to their normal indicators after 2-4 days. If they decrease too much, calcium gluconate therapy will be carried out. Over time, the blood calcium levels may return to normal, but some patients will need a long-term intake of oral calcium supplements to increase their blood calcium levels.
If you are going to have your parathyroid adenoma treatment in one of the German hospitals, you are welcome to use the Booking Health service. You can compare the cost of treatment and make an appointment at the best price. The Booking Health staff will help you to choose the most suitable clinic in Germany and arrange your trip.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Centers for Disease Control and Prevention
Healthline
Google Scholar
