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Transoral Vestibular Approach Parathyroidectomy: Patient Selection Considerations and Technique

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Transoral Neck Surgery

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Abstract

Hyperparathyroidism results from excessive and inappropriate secretion of parathyroid hormone (PTH), and the disease process can be primary, secondary, or tertiary. Diagnosis of hyperparathyroidism is purely biochemical; however, indications for surgery include symptoms and patient factors. Localization of disease is key for determining surgical approach and can assist in surgical planning, while intraoperative adjuncts such as intraoperative PTH monitoring can also assist in decision-making. Many attempts have been made to develop minimally invasive approaches to parathyroidectomy and to optimize preoperative planning to limit the amount of dissection required to find hyperfunctional glands. The most recent variation on access is the transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) to avoid a cutaneous incision in those desiring so. Excellent preoperative localization is imperative, although the optimal role of the various adjuncts mentioned above remains to be defined for this technique.

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Authors and Affiliations

  1. Weill Cornell Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA

    Toni Beninato

  2. Department of General Surgery, University of Vermont Medical Center Porter Hospital, Middlebury, VT, USA

    Elya Vasiliou

  3. Department of Otolaryngology – Head & Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jonathon O. Russell

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  1. Toni Beninato
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  2. Elya Vasiliou
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  3. Jonathon O. Russell
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Correspondence to Jonathon O. Russell .

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Editors and Affiliations

  1. Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine Otolaryngology – Head and Neck Surgery, Baltimore, MD, USA

    Jonathon O. Russell

  2. Department of Surgery, University of Kentucky, Lexington, KY, USA

    William B. Inabnet III

  3. Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine Otolaryngology – Head and Neck Surgery, Baltimore, MD, USA

    Ralph P. Tufano

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Beninato, T., Vasiliou, E., Russell, J.O. (2020). Transoral Vestibular Approach Parathyroidectomy: Patient Selection Considerations and Technique. In: Russell, J., Inabnet III, W., Tufano, R. (eds) Transoral Neck Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-30722-6_13

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  • DOI: https://doi.org/10.1007/978-3-030-30722-6_13

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