Potential Complications of Parathyroid Surgery

‍Potential complications following surgery

1. Voice changes
2. Transient low calcium levels
3. Persistent high calcium levels
4. Post-operative bleeding
5. Swallowing discomfort
6. Wound infection
7. Scarring

Voice changes

Several factors may contribute to the observed changes:

Injury to the Recurrent Laryngeal Nerve(s):

The recurrent laryngeal nerves, situated on each side of the neck, navigate behind the thyroid gland and extend into the larynx, governing vocal cord movements.

If these nerves are "bruised" during surgery, immediate dysfunction may occur, with subsequent recovery expected in the days or weeks following the procedure. In some cases, however, the restoration of normal voice function might take several months.

Permanent damage to one nerve (approximately 1 in 100 cases) can result in a hoarse, croaky, and weak voice. While the body often adapts over time, persistent voice issues beyond three months prompt a referral for voice therapy. In certain instances, specialized surgery may be necessary to enhance vocal quality.

Although rare, permanent damage to both nerves poses a serious concern, potentially requiring the placement of a permanent tracheostomy (breathing tube) into the neck's windpipe.

The complication rates of nerve injury following operations performed by Mr Jeddy have been audited and found to be less than one percent. 

Non-specific Voice Changes:

Any neck surgery can induce alterations in voice quality, even in the absence of nerve injury affecting vocal cord movement.

Fortunately, these non-specific voice changes are typically subtle and resolve within a few months post-operation. Individuals may notice a slightly deeper voice and experience voice fatigue, particularly significant for those reliant on their voice for professional purposes.

Transient low calcium levels

Following parathyroid surgery, there is a possibility of temporary reduction in calcium levels in some cases. This is typically a transient phenomenon as the body readjusts its calcium balance. 

Patients usually experience tingling or spasms in your lips, fingers, or toes after the procedure, it could signal a potential decrease in calcium levels. To avoid these symptoms, patients are given calcium supplements in the early post-operative period. 

Nevertheless, in some cases after parathyroid surgery and despite calcium supplements, calcium levels may drop too low. This is very rare whilst the body regains balance of calcium levels. Your surgical team will check for this postoperatively. If you feel tingling or spasms in your lips, fingers or toes after the operation, then this could be an indication that your calcium levels may be low, and you will need to contact Mr. Jeddy or his surgical team to measure you calcium levels and treat it appropriately. 

Calcium Levels Remaining High Despite Surgery

There are instances where blood calcium levels persistently remain elevated despite the surgical intervention, however this is extremely rare and occurs in approximately 2 out of every 100 operations.  This suggests that the operation did not effectively cure the underlying condition. This typically occurs because of the presence of an additional abnormal parathyroid or, less commonly, the inability to locate the parathyroid during the operation. 

Mr. Jeddy will offer comprehensive guidance on the upcoming actions, which might involve a reassessment by repeating the tests and scans conducted earlier to gain further insights. In specific circumstances, more extensive tests may be required, and your surgical team will provide detailed explanations for these procedures.

Post-operative bleeding

This is a rare complication that may result in neck discomfort or, in more severe instances, breathing difficulties. In some cases, patients may require a return to the operating theatre for additional surgery to investigate the neck further and address the source of bleeding.

Swallowing discomfort

After a neck exploration, you should regain the ability to eat and drink normally. However, some patients may experience a sensation of a lump in their throat while swallowing. This occurrence is typical and tends to resolve over time.

Wound infection

Infection is infrequent, but if it occurs, it can be effectively treated with antibiotics.

Scarring

Occasionally, the scar may appear red in the initial months post-operation before gradually fading into a thin white line. The final appearance of the scar typically takes six months to one year to fully manifest. While uncommon, a small number of patients may experience the development of a thick, exaggerated scar, although this is a rare occurrence and not the norm.

Potential anesthetic complication

General anesthesia is highly secure, and serious complications are infrequent. Mr Jeddy works with senior UK anesthetists with specialized training, ensuring a high standard of care.

Post-anesthesia, it's not uncommon for some patients to experience nausea or vomiting. Your anesthetist will provide medication to mitigate these occurrences, tailored to your specific needs. Temporary issues such as sore throat, dizziness, blurred vision, headache, itching, aches, pains, and backache may arise but typically improve within hours of waking.

Less common problems (1 in 1000 patients) include the potential for a chest infection (especially in those with existing chest conditions), muscle pains, dental issues, or the exacerbation of pre-existing medical conditions.

Very uncommon problems (1 in 10,000 patients) involve rare occurrences such as eye damage, serious drug allergies, and nerve damage. The risk of awareness (remaining conscious) during general anesthesia is also very rare (1 in 10,000). If awareness does occur, it's typically brief before the operation begins, and being conscious during the operation is extremely rare.

Your individual risk factors, including any existing illnesses, personal habits (such as smoking or obesity), or the complexity and urgency of the surgery, will determine your specific risk profile. Rest assured, your safety is our utmost priority throughout every stage of your medical journey