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Dr. Peter Ashman, MD is a pediatric otolaryngologist in New York, NY specializing in pediatric otolaryngology (ear, nose & throat). Dr. Peter Ashman, MD is affiliated with ENT and Allergy Associates (ENTA) (New Jersey and New York), ENT and Allergy Associates and ENT AND ALLERGY ASSOCIATES LLP.
150 East 58th Street 34th Floor
New York, NY 10155
Parathyroid Surgery
Parathyroid surgery is a procedure done to identify and remove diseased parathyroid glands. These tiny glands in the neck regulate calcium levels in the body. Occasionally, one or more of the parathyroid glands can become hyperactive, swelling and causing too much calcium to be moved from the bones to the bloodstream. This is called hyperparathyroidism, and it can cause problems including weakness, nervous system disorders, and kidney problems. To treat hyperparathyroidism, overactive parathyroid glands are removed.
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.
Thyroid Problems
Thyroid problems are a group of conditions that alter hormone regulation and metabolism. The thyroid is a small, butterfly-shaped gland located in the lower neck, just below the Adam's apple (laryngeal prominence) and larynx (voice box). Despite its small size, the thyroid has an outsized effect on the body by regulating hormones that control metabolism. Metabolism is the body's process of converting consumed food into fuel to power the entire body. Heart rate, weight, cholesterol, body temperature, and even physical growth and development are all affected by the metabolism.
When the thyroid malfunctions, the body is unable to properly process and allocate energy. Thyroid problems, such as hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid), cause irregular metabolism. In some cases, the body produces antibodies that attack the thyroid cells for unknown reasons. The damaged thyroid responds by releasing either too little or too much T3 and T4 thyroid hormones. Thyroid malfunctions may also arise from genetic causes or iodine deficiency. Thyroid problems may include:
Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.
Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.
Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.
The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.
Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.
He has a state license in New York.
Licensed In: New York
Dr. Peter Ashman, MD is associated with these hospitals and organizations:
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Dr. Peter Ashman's area of specialization is otolaryngology (ear, nose, and throat). Dr. Ashman is affiliated with ENT and Allergy Associates (ENTA) (New Jersey and New York). He trained at a hospital affiliated with UMDNJ-Robert Wood Johnson Medical School for his residency. He usually honors Health Insurance Plan of New York (HIP), UnitedHealthcare, and Elderplan, in addition to other insurance carriers.