Cleveland Head and Neck Clinic

Thyroid and Parathyroid Disease

The thyroid gland is located in the lower part of the neck, just above the sternum/breastbone. It produces thyroid hormone which controls the rate of metabolism. Sometimes the gland makes too much hormone (hyperthyroidism) or too little hormone (hypothyroidism). It also may become enlarged (goiter), or form nodules and tumors that appear as a visible swelling on a physical exam. They may be found on other studies such as CT scans or ultrasounds of the neck. Symptoms may include an abnormal sensation of pressure, trouble swallowing, hoarseness, or pain.

Evaluation of the thyroid includes blood tests, a thyroid ultrasound, and possibly a fine needle biopsy. Thyroid conditions may be treated with medicines or surgery may be recommended. Surgical treatment includes removing part of the gland (lobectomy) or all of it (total thyroidectomy). Often this surgery is performed as an outpatient.

The parathyroid glands are four small glands usually located behind the thyroid gland, two glands on each side, that secrete parathyroid hormone (PTH), a hormone involved in calcium metabolism. A benign tumor of this gland (adenoma) can form and produce too much PTH, which in turn causes abnormally high levels of calcium with loss of calcium out of the bones. Classic symptoms include bone pain, aches, and kidney stones. Other symptoms may be mild and nonspecific and include weakness, stomach upset, abdominal pain, nausea, decreased appetite, or depression. Blood tests confirm the diagnosis and the location of the culprit gland is usually identified with ultrasound and/or parathyroid scan.

Removal of parathyroid gland tumors is performed as an outpatient surgical procedure.