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The effect of parathyroidectomy on patients' symptoms in tertiary hyperparathyroidism
Author(s) -
See Anna,
Lim Amy E. L.,
Wong Jiunn,
Choong Hui Lin,
Iyer N Gopalakrishna,
Tan Hiang Khoon,
Tan Ngian Chye,
Ng Jeremy C. F.
Publication year - 2019
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.25750
Subject(s) - parathyroidectomy , medicine , tertiary hyperparathyroidism , hyperparathyroidism , primary hyperparathyroidism , secondary hyperparathyroidism , surgery , urology , parathyroid hormone , gastroenterology , calcium
Background The efficacy of parathyroidectomy for primary and secondary hyperparathyroidism is well‐established but evidence in tertiary hyperparathyroidism is lacking. We examined parathyroidectomy's effect in tertiary hyperparathyroidism. Methods Patients with tertiary hyperparathyroidism who underwent parathyroidectomy were followed up for 12 months. A modification of the 13‐item parathyroid symptoms list developed by Pasieka was administered at 0, 1, 3, 6, and 12 months post‐surgery. We also examined if preoperative factors would predict symptom improvement post‐surgery. Results Ninety‐one patients were included. Survey response rates at 1, 3, 6, and 12 months post‐surgery were 97.8%, 90.1%, 82.4%, and 80.2%, respectively. Mean preoperative Pasieka parathyroid score (PSS) was 6.3 ± 2.7. At first month, PSS decreased to 2.9 ± 2.0 ( P < .001) and was sustained at 3, 6, and 12 months (2.7 ± 2.1, P < .001, 2.3 ± 1.6, P < .001 and 3.4 ± 2.5, P < .001). The degree of PSS reduction at 1‐month post‐parathyroidectomy correlated strongly with preoperative symptom severity (Pearson's coefficient: 0.690, P < .001). Conclusions Parathyroid symptoms unequivocally improve post‐parathyroidectomy. The greatest degree of improvement was observed in early postoperative period up to 6 months.