Albright’s 1934 description of primary water clear cell hyperplasia, that involving all four parathyroids represents the first recognition of the concept of primary hyperparathyroidism (PHPT) due to multiple gland disease (MGD) rather than single-gland disease. Although the incidence of this…
Introduction Intraoperative parathyroid hormone monitoring (IPM) has been used since the 1990s to guide the excision of abnormal parathyroid glands in patients with sporadic primary hyperparathyroidism (SPHPT). Currently, many high-volume parathyroid surgeons use IPM, selectively or routinely, to guide parathyroidectomy…
Introduction Bilateral neck exploration (BNE) with the identification of at least four parathyroid glands and the removal of pathologic parathyroid tissue has represented, for several decades, the standard of treatment of primary hyperparathyroidism (PHPT) (see Chapter 56 , Standard Bilateral…
Video 57.1 Minimally Invasive Parathyroidectomy. Background Subsequent to the first parathyroidectomy documented in the literature (in 1925 by Felix Mandl of Vienna), four-gland exploration via a generous incision was the standard technique until the 1970s and 1980s. The advent of…
Video 56.1 Introduction to Chapter 56, Standard Bilateral Parathyroid Exploration. Modern management of parathyroid disease has evolved with the influence of several fundamentally new and important factors. First is the reality that primary hyperparathyroidism (PHPT) is no longer a rare…
In this chapter, we discuss the current approach to preoperative workup for primary hyperparathyroidism (primary HPT), determine appropriate surgical candidacy, review parathyroid surgical anatomy, and detail a comprehensive search algorithm for surgical exploration. Preoperative Evaluation Background Primary HPT is a…
Video 54.1 Introduction to Chapter 54, Guide to Preoperative Parathyroid Localization Testing. Introduction The skill of an experienced parathyroid surgeon remains the most important asset in identifying abnormal parathyroid glands. Results of initial operations for primary hyperparathyroidism (PHPT) are similar…
Primary hyperparathyroidism (PHPT) is characterized classically by hypercalcemia and levels of parathyroid hormone (PTH) that are frankly elevated or inappropriate in the presence of hypercalcemia. Patients with the disease today in the United States bear little resemblance to those with…
Video 52.1 Introduction to Chapter 52, Medical Treatment Horizons for Metastatic Differentiated and Medullary Thyroid Cancer. Introduction Metastatic differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC) are rare tumors with limited treatment options and an overall poor response to…
Video 51.1 Floating Debris Video 51.2 Percutaneous Ethanol Injection: Cyst Injection Video 51.3 Percutaneous Ethanol Injection: Toxic Adenoma Video 51.4 Percutaneous Ethanol Injection: Metastasis Video 51.5 Ultrasound Cord Check Introduction Thyroid neoplasms and cysts are common in the general population.…