How is a traditional parathyroidectomy performed?
The procedure is performed under general anaesthesia with an endotracheal tube or laryngeal mask (please see anaesthetic section). The patient is supine with a 20% tilt of the head in an upward position. A shoulder support is placed between the shoulders, and the head supported on aring with the neck extended. If there is any evidence of cervical bone disease this is omitted. Approximately 1 cm above the breastbone a 4 cm incision is made through skin and platysma. Care is taken to avoid the cutaneous branches of the cervical nerve plexus, as damage to these nerves results in numbness in the front of neck, which can cause difficulty for men when shaving. The incision is so small that the anterior jugular veins are easily avoided and rarely damaged. The skin and platysmal flaps are raised down to the base of the sternal notch and up to the thyroid cartilage. The mid-line between the sternohyoid strap muscles is found low in the neck and the central fascia divided (this a totally bloodle
