Surgery is the treatment of choice for symptomatic hyperparathyroidism. Complications of parathyroidectomy include bleeding, recurrent laryngeal nerve injury, and hypoparathyroidism. Unilateral recurrent laryngeal nerve injury presents with postoperative hoarseness. Bilateral nerve injury is a rare but serious complication, resulting in aphonia and requiring immediate intubation. Following parathyroidectomy, serum calcium is expected to decrease within 24 hours. Patients with significant preoperative bone disease may present with “hungry bone” syndrome following removal of the parathyroid gland. This results in hypocalcemia due to the rapid remineralization of bone. Serum calcium usually reaches a nadir within 3 to 7 days postoperatively. During this time, serum calcium, magnesium, and phosphorus levels should be monitored until stable.
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