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Intraoperative parathyroid hormone monitoring to determine long‐term success of total parathyroidectomy for secondary hyperparathyroidism
Author(s) -
Moor James W.,
Roberts Steven,
Atkin Steven L.,
England R. James A.
Publication year - 2011
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21441
Subject(s) - parathyroidectomy , parathyroid hormone , medicine , primary hyperparathyroidism , secondary hyperparathyroidism , hyperparathyroidism , urology , nomogram , surgery , calcium
Background Use of intraoperative parathyroid hormone (ioPTH) monitoring during total parathyroidectomy for secondary hyperparathyroidism is common, although its ability to predict long‐term normoparathyroid state is not known. Methods Prospective evaluation of 57 consecutive patients undergoing total parathyroidectomy for renal hyperparathyroidism with ioPTH monitoring and follow‐up PTH assays were used to categorize the patients into 3 groups: success, adequate biochemical control, and failure. Results There was no statistically significant difference in percentage reduction of ioPTH between the 3 groups ( p = .07), although there was a moderate negative correlation between percentage reduction of ioPTH and percentage reduction of PTH at follow‐up ( R = 0.57). Conclusions When used under current guidelines, ioPTH monitoring is of no use in predicting long‐term cure for these patients because it does not predict success. Patients that undergo total parathyroidectomy are required to have long‐term calcium and PTH assay follow‐up because normoparathyroidism cannot be assumed. Using the regression equation calculated, success may be predicted for future patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2010