Otolaryngology, Head and Neck Surgery
Primary hyperparathyroidism is a common condition with surgery being the definitive treatment modality. Controversy exists over the extent of optimal neck exploration, whether unilateral or bilateral exploration should be performed, particularly since 85-90% of primary hyperparathyroidism results from single gland disease. Unilateral neck exploration is now considered to be adequate unless a definitive adenoma is not identified on ipsilateral exploration and where the serum intact Parathyroid Hormone (iPTH) level does not show a decline greater than 60% after removal of a suspected adenoma. It also avoids the potential risk of hypocalcaemia, recurrent laryngeal nerve injury along with extended anaesthesia and operative time and in-patient stay. With the advent of advanced imaging modalities and peri-operative localization techniques the hyper-functioning gland can be identified and minimally invasive procedures can be performed, limiting the neck exploration to only the abnormal gland. Here we would like to describe our procedure for a minimally invasive endoscopic selective parathyroidectomy, performed on five patients. We describe our standard setup, procedure and the outcomes.
Journal of the Pakistan Medical Association
(2012). Minimally invasive endoscopic selective parathyroidectomy. Journal of the Pakistan Medical Association, 62(4), 402-5.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_otolaryngol_head_neck/6