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Role of parathyroid hormone monitoring during parathyroidectomy
Author(s) -
Bachar Gideon,
Mizrachi Aviram,
Hadar Tuvia,
Feinmesser Raphael,
Shpitzer Thomas
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.21666
Subject(s) - medicine , parathyroidectomy , primary hyperparathyroidism , parathyroid hormone , ultrasonography , hyperparathyroidism , surgery , nuclear medicine , calcium
Background The value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy has been previously debated. Methods This retrospective analysis was of 240 patients, operated on for primary hyperparathyroidism (PHPT) between January 2002 and January 2006 and categorized into 3 groups by preoperative and intraoperative modalities: group 1 ( n = 109), technetium 99m sestamibi (MIBI), ultrasonography, and IOPTH; group 2 ( n = 102), ultrasonography and MIBI; and group 3 ( n = 29), ultrasonography and IOPTH. Sensitivity and specificity were calculated. Results In group 1, IOPTH increased the success rate from 97% to 99%. In group 2, ultrasonography and MIBI were concordant in 95% of cases. In group 3, IOPTH increased the sensitivity from 89% to 96%. The duration of surgery was longer ( p < .0001) when IOPTH was applied. Conclusions When ultrasonography and MIBI are used, the additional benefit of IOPTH is marginal, especially given the longer duration of surgery. Ultrasonography and additional IOPTH yield good success rates when MIBI is not available. © 2011 Wiley Periodicals, Inc. Head Neck, 2011