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Split central venous sampling of parathyroid hormone: An adjunct to surgical exploration
Author(s) -
Maceri Dennis R.,
Kokot Niels,
Green Kathrine,
Montgomery Vida,
Sharifi Jahangir
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.21659
Subject(s) - medicine , jugular vein , internal jugular vein , parathyroid hormone , vein , radiology , surgery , calcium
Background Minimally invasive parathyroid surgery mandates preoperative localization of the adenoma for a targeted operative approach. This technique uses split internal jugular vein parathyroid hormone (PTH) samples to determine a gradient that then directs the surgical exploration. Methods Blood samples were drawn low in the neck from the jugular veins after the neck was opened. The p values for the difference in PTH between the right and left internal jugular veins were calculated with independent sample t tests. Results For left‐sided adenomas, the left internal jugular vein mean was significantly higher than the right p = .001). For right‐sided adenomas, the right internal jugular vein mean was significantly higher than the left ( p = .004). In hyperplasia, there was no significant difference ( p = .43). Conclusions This study demonstrates the usefulness of split PTH internal jugular vein samples in patients in whom preoperative localization failed. Eighty percent of these patients with a gradient were treated with site‐directed unilateral exploration. © 2011 Wiley Periodicals, Inc. Head Neck, 2011