Role of parathyroid hormone monitoring during parathyroidectomy

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Abstract

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.

Original languageEnglish
Pages (from-to)1754-1757
Number of pages4
JournalHead and Neck
Volume33
Issue number12
DOIs
StatePublished - Dec 2011

Keywords

  • parathyroid adenoma
  • parathyroid hormone monitoring
  • primary hyperparathyroidism
  • technetium 99m sestamibi
  • ultrasonography

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