The parathyroid glands are small endocrine glands, about the size of a lentil, typically located behind the thyroid gland. Their main function is to regulate blood calcium and phosphorus levels by producing parathyroid hormone (PTH), which is essential for bone, muscle, and neurological health.
In most people there are four glands (two upper and two lower), although both the number and the location can vary. In some patients, one or more glands may be found in ectopic locations, outside the neck—for example, within the thymus or in the mediastinum.
Relationship to nearby structures
The parathyroid glands are located in an anatomically complex region, very close to highly relevant structures such as the recurrent and superior laryngeal nerves—which control vocal cord movement—the trachea, the esophagus, and the neck vessels. For this reason, parathyroid surgery requires precision, experience, and detailed anatomical knowledge in order to preserve vocal and respiratory function, ensuring maximum procedural safety.
Primary hyperparathyroidism (PHPT) is the most common disease of the parathyroid glands. It occurs when one or more glands begin to produce an excessive amount of parathyroid hormone (PTH), leading to increased blood calcium levels (hypercalcemia).
The diagnosis of primary hyperparathyroidism is biochemical, based on simultaneous elevation of serum calcium and PTH. Once confirmed, additional studies are performed to assess the impact this imbalance may have had on the body, such as:
Not all patients with primary hyperparathyroidism require surgery. In some mild or asymptomatic cases, medical treatment and endocrine follow-up may be chosen, especially if calcium levels are moderate and there are no bone or kidney complications.
Several scientific societies—such as the American Association of Endocrine Surgeons (AAES) and the 5th International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism—have established precise criteria in which surgery has shown significant benefits:
Once surgical treatment is indicated, localization studies are performed to identify the gland or glands responsible for hyperfunction and to plan a precise operation. The most commonly used methods include:
The definitive treatment for primary hyperparathyroidism is parathyroidectomy, which consists of removing the affected gland. In most cases, it can be performed through minimally invasive surgery, with fast recovery and excellent cosmetic outcomes.
During surgery, advanced tools may be used to increase safety and effectiveness:
Secondary hyperparathyroidism occurs when the parathyroid glands are chronically stimulated by low calcium levels, most commonly due to chronic kidney disease, prolonged vitamin D deficiency, or intestinal malabsorption disorders. Over time, this stimulation may become persistent, leading to tertiary hyperparathyroidism, in which the glands remain overactive even after the original cause has been corrected.
Dr. Alejandro Yanzon performs more than 250 thyroid and parathyroid surgeries per year. His experience—and that of his team—makes it possible to provide comprehensive, precise, and personalized care, based on the highest international standards and the most current scientific evidence.
Managing parathyroid disorders requires collaboration among multiple medical specialties. Dr. Yanzon works with a highly specialized multidisciplinary team, made up of professionals from Integralis, the Hospital Italiano de Buenos Aires, and other reference institutions.
The team includes experts in: