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Is bilateral exploration still the standard of care for primary hyperparathyroidism?: Outcomes of focused radio‐guided parathyroidectomy and bilateral explorations
Author(s) -
Cappello Zachary J.,
Bumpous Jeffrey M.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24084
Subject(s) - medicine , parathyroidectomy , primary hyperparathyroidism , surgery , radiology , parathyroid hormone , calcium
BACKGROUND Primary hyperparathyroidism (HPT) is a relatively common surgical disease caused principally by singlegland enlargement and hyperfunction. In experienced hands, 95% of patients are rendered normocalcemic after parathyroidectomy, with minimal morbidity. Traditionally, a bilateral neck exploration (BNE) is the technique of choice. However, new methods are continually being explored to further increase the success rate and decrease the morbidity, including intraoperative ultrasonography, methylene blue localization, selective venous sampling, intraoperative intact parathyroid hormone monitoring, sestamibi scanning, four-dimensional computed tomography, and the use of radio guidance. In this Triological Society Best Practice review, we examined the evidence regarding the use of intraoperative radio guidance for parathyroidectomy in primary HPT compared to the use of the traditional BNE procedure.