, neck exploration for hyperparathyroidism has about a 96% success rate in curing hyperparathyroidism. That means that there is about a 4% chance of the operation not correcting the hyperparathyroidism.
There are basically 3 reasons why thyroid surgery might not correct the problem. First, the diagnosis might not be correct. There are a number of different things which can elevate the calcium in the blood, including cancers, some medications, some inflammatory conditions, etc.. The amount of parathyroid hormone in the blood can now be measured accurately, and proper interpretation of the results of this test has greatly increased the accuracy of diagnosis of hyperparathyroidism. Secondly, the surgeon may not be able to locate the abnormal parathyroid gland or gland in the neck. Surgeons who do a lot of thyroid surgery are more likely to be able to find the abnormal glands, but even very experienced surgeons will not always be able to find all of the abnormal parathyroid glands and thereby correct the hyperparathyroidism . Thirdly, very occasionally the abnormal parathyroid gland or glands are not in the neck but in the chest, in which case, obviously, even the best parathyroid surgeon cannot find it by looking in the neck.
There are many different types of scans which can be done before thyroid surgery to try to find the abnormal parathyroid gland or glands. These include sonic or ultrasound scans, CAT scans, MRI scans, and nuclear medicine sestamibi scans. These scans, even taken all together, are not as successful at localizing all of the abnormal parathyroid as is an experienced parathyroid surgeon. Therefore most endocrine surgeons do not think these scans are necessary or useful prior to thyroid surgery unless the newer "minimally invasive radioguided" approach discussed below is used. Theses scans can be useful when patients have recurrent or persistent disease after a previous operation for hyperparathyroidism, however, or when patients have had previous thyroid surgery.
Learn more about thyroid surgery and additional General Surgery procedures at the Wake Forest University Baptist Medical Center. One of the nation's preeminent academic medical centers, WFUBMC is an integrated health care system that operates 1,291 acute care, rehabilitation and long-term care beds, outpatient services, and community health and information centers. The Medical Center's component institutions carry out a joint mission of patient care, education, research and community service. The partnership includes three major members: Wake Forest University Health Sciences, North Carolina Baptist Hospital, and Wake Forest University Physicians.