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Parathyroidectomy

  • Lilah F. MorrisEmail author
  • Michael W. Yeh
Chapter

Abstract

Parathyroidectomy is definitive treatment for sporadic, primary hyperparathyroidism with cure rates as high as 98 % at expert centers. We explore the predictive value of preoperative localizing studies including 99mTc-sestamibi scan, ultrasound, and four-dimensional CT scan. Operative technique for bilateral neck exploration is described with special attention given to anatomic principles. While there are multiple techniques for limited exploration — defined as a unilateral, image-directed parathyroidectomy involving an incision measuring 2.5 cm or less — we describe the lateral mini-incision approach. Although uncommon, complications of parathyroidectomy include hematoma, hypocalcemia, permanent hypoparathyroidism, nerve injury, and operative failure. Finally, we address the advantages, disadvantages, and controversies of four-gland versus limited exploration.

Keywords

Sporadic primary hyperparathyroidism Parathyroid adenoma Bilateral neck exploration Minimally invasive parathyroidectomy 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of SurgeryNorthwest Allied General Surgery, Northwest Medical CenterTucsonUSA
  2. 2.Department of Surgery, Section of Endocrine SurgeryUCLA David Geffen School of MedicineLos AngelesUSA

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