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What You Should Know About Treating Hyperparathyroidism

  • Hyperparathyroidism can be treated 90 percent of the time with the surgical removal of a single dysfunctional parathyroid gland.
  • Removal of more than one dysfunctional parathyroid gland is required in 10 percent of hyperparathyroidism cases.
  • Not everyone with hyperparathyroidism should have surgery. Many high-risk patients, for example, those with renal failure, are often treated with medication. Endocrinologists are the most-qualified subspecialists trained to make difficult decisions on which patients should have parathyroid surgery.
  • When minimally invasive parathyroid surgeons rely on only the Sestamibi parathyroid probe to find a parathyroid tumor, they run the risk of performing a noncurative surgery 10 percent of the time, because this technique is not effective in the detection of more than one parathyroid tumor.
  • Use of intra-operative rapid PTH monitoring is the only reliable technology available for documenting parathyroid surgical success in the operating room.
  • Many hospital neck ultrasounds are performed by technicians and subsequently interpreted by radiologists. Most hospital X-ray and ultrasound technicians lack the specialized experience to recognize parathyroid shadows on neck ultrasounds. Thus, the likelihood that a parathyroid tumor will be noticed by a hospital X-ray technician may be small. If ultrasound technicians do not notice parathyroid tumors while they are performing scans, there's a great chance the radiologist will miss them when reviewing the pictures.
  • The management of hyperparathyroidism has evolved rapidly in the past decade with the introduction of intraoperative parathyroid hormone testing, radio-guided surgery, and endoscopic surgery. Not surprisingly, there is a corresponding movement toward specialization of surgeons providing increasingly sophisticated treatments for head and neck endocrine disorders.*
  • Traditional parathyroid surgery requires a 3- to 5-inch incision across the neck. The procedure requires cutting skin and two muscle layers and then dissecting and lifting the thyroid, so that all four glands can be visualized. The typical duration of surgery is two hours.
  • Studies have shown that minimally invasive radio-guided parathyroid surgery (MIRP) has a 95 percent success rate. Surgical procedures typically require less than 30 minutes of operating room time. Patients rarely require an overnight stay in the hospital and recovery is often quick and painless.

* Terris, D. J., Chen, N., Seybt, M. W., Gourin, C. G. and Chin, E. (2007), Emerging Trends in the Performance of Parathyroid Surgery. The Laryngoscope, 117: 1009–1012. doi: 10.1097/MLG.0b013e3180485716. PubMed.gov, U.S. National Library of Medicine.



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