Conventional Surgical Management of Primary Hyperparathyroidism

  • Leslie S. Wu
  • Sanziana Roman


Primary hyperparathyroidism is the most common form of hyperparathyroidism (HPTH) and is the most frequent explanation for hypercalcemia in the outpatient setting. Population-based estimates reveal an overall incidence of approximately 25 per 100,000 in the general population, with 50,000 new annual cases. The peak incidence is in the fifth and sixth decades of life, with a female to male ratio of 3:1. Some studies have estimated the overall prevalence of HPTH in the elderly at 2–3%, with approximately 200 cases/100,000 population.

Parathyroidectomy with bilateral neck exploration (BNE) has been the treatment of choice for primary HPTH for many decades. With the advent of new preoperative and intraoperative parathyroid localization modalities, the concept of “focused” or minimally invasive parathyroidectomy has become commonplace. Nonetheless, an understanding of the conventional surgical management remains paramount for the successful treatment of primary HPTH. This time-tested dissection by an experienced endocrine surgeon continues to be the gold standard to which all other procedures are compared.


Parathyroid Gland Recurrent Laryngeal Nerve Parathyroid Carcinoma Parathyroid Tissue Parathyroid Tumor 
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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of SurgeryMaine Medical CenterPortlandUSA
  2. 2.Department of SurgeryYale University School of MedicineNew HavenUSA

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