Dr. Joseph Zenga, MD

One kind of parathyroid surgery is called bilateral neck exploration. The surgeon finds and looks at all of the parathyroid glands on both sides of the neck, visually identifying any that are diseased and removing them. Minimally invasive, or focused, parathyroidectomy is done to remove a single diseased gland. The gland causing problems is identified before surgery using localization techniques such as hormonal or radiology testing. Since in most cases only one gland is causing problems, focused parathyroidectomy is a common alternative to bilateral neck exploration. Both procedures are safe and effective.

In the rare case that all four glands are diseased, the surgeon will either remove three and a half glands and leave one half in place, or all four will be removed and part of one gland will be transplanted into the forearm. This is done to keep calcium levels where they should be.

After surgery, patients will have a bandage on their neck and a sore throat. Patients may only want liquids or very soft food for the first day, and thy may be asked to take calcium supplements for a while until their remaining parathyroid glands begin functioning well again. Recovery is fairly quick, and within a few days patients should be feeling like themselves again.

Professional cosmetic skin treatments exist to treat wrinkles, scars, dark spots, remove excess hair, tone and tighten skin, and otherwise improve the appearance of the skin. They may use lasers, light therapy, chemical peels, microdermabrasion, or many other forms of skin treatment.

Acne occurs when hair follicles become clogged with oil and dead skin cells, most commonly on the face or back. The clogged follicles can then become infected and inflamed. Treatments include antibiotics, anti-inflammatories, and retinoid creams.

Eczema is dry, sensitive skin that causes an itchy red rash, often in response to specific triggers. It is common in childhood but can sometimes last into adulthood. The main treatment involves keeping skin well moisturized.

Dermatitis is the medical name for any kind of skin inflammation or rash. Rashes can happen because of an allergy or contact with an irritating substance. They may be red, itchy, or even painful. They are often treated with antihistamines or moisturizing creams containing cortisone.

Psoriasis is patches of thick, red skin that is covered in silvery scales. It is often itchy and sore. Psoriasis is thought to be caused by an immune disorder, and it runs in families. Psoriasis is not contagious. There is no cure, but there are medicated creams available to treat the symptoms.

Skin growths, including warts and moles, are usually not serious. However, some skin growths should be examined by a doctor to make sure they don't cause problems in the future. Warts are harmless, rough, bumpy growths caused by a viral infection. They occur most often on the hands and feet. Because they are caused by a virus, they are contagious. Moles are brown or black spots that are sometimes raised slightly from the surface of the skin. They happen when clumps of pigment cells form in a cluster instead of spread out. Moles are harmless except that they are more vulnerable to cancer than other parts of the skin. Skin cancer is the most common form of cancer in the United States, and its risk increases with sun exposure and fair skin tone.

Skin issues can be embarrassing or irritating, but most are minor and can be treated without serious problems. Some, however, can be a sign of a more significant issue, so it is important to see a doctor for anything out of the ordinary.

Both hypothyroidism and goiters are caused by an autoimmune reaction where the body produces antibodies that attack the thyroid cells for unknown reasons. The thyroid reacts by releasing too little or too much T3 and T4 thyroid hormones, impairing thyroid function and causing irregular metabolism. Goiters develop from the autoimmune reaction causing continued antibody damage to the thyroid over time. Thyroid goiters are large, swollen lumps that can be felt near the base of the neck. Obstructive goiters can cause pain, coughing, and abnormal breathing. Hypothyroidism may also be caused by iodine deficiency, as iodine is needed to produce thyroid hormones.

The exact cause of thyroid cancer and thyroid nodules or cysts is unknown. While thyroid cancer and thyroid nodules or cysts can occur in individuals with thyroid disorders, they are not associated with a malfunctioning thyroid.

Physicians may prescribe thyroid surgery if blood tests reveal patients' thyroid stimulating hormones (TSA) are outside of the acceptable range, indicating a malfunctioning thyroid. Thyroid biopsies (tissue samples) and tests for thyroid-attacking antibodies are also criteria for surgery.

An ENT or general surgeon performs thyroid surgery. While a patient is placed under anesthesia, the surgeon makes an incision at the center of the neck and removes the thyroid gland. Two alternative methods of thyroid surgery are transoral (incision through the mouth) and endoscopic, where a surgeon operates a video camera for live footage to help guide the removal process.

Thyroid surgery requires minimal aftercare. Most patients recover quickly and resume normal activities within a few days of surgery. However, thyroid surgery patients must take daily synthetic thyroid medication (levothyroxine) for life to replace their removed thyroid.