Parathyroids

Parathyroid Hormone: PTH

Primary Hyperparathyroidism

Elevated Blood Calcium Level Î CaElevated Parathyroid Hormone Level Î PTHExcessive Calcium in UrineThinning of Bones: Dexa Scan

Cause: Parathyroid Adenoma

Symptoms Hyperparathyroidism

Population: Women 40-75Stones

Bones

Abdominal Groans

Osteoporosis

Osteoporosis

Tibia Bone Loss

Primary Hyperparathyroidism

Serum Calcium (ionized) ÎSerum PTH Î Excessive Calcium in UrineThinning of Bones

Diagnosis and Tests

Parathyroid AdenomaBenign Tumor of PT Gland

Parathyroid Scan

Parathyroid Scan

Parathyroid Ultrasound

Neck Exploration

Parathyroid Adenoma

Mini-Incision Parathyroidect

omy

Lateral Approach to Parathyroids

Benefits of Preoperative Localization

Smaller IncisionShorter Operative TimeDifferent Anesthesia OptionsAmbulatory vs. OvernightDecrease Rate of Missed or Multiple Adenomas

Controlled Surgical Environment

Aberrant Locations and Multiple Adenomas

Aberrant Location: 5-10%Multiple Adenomas: 10-20%

Surgical Preparation

IOPTHGamma CounterNerve Dissector

Equipment