Preoperative Localization in Primary Hyperparathyroidism Surgery

Objective:

Primary hyperparathyroidism is the disturbance of calcium metabolism as the result of excessive parathormone secretion. The most common cause is parathyroid adenoma. The need for localization methods and preference of surgical methods are still subject to debate, especially in primary parathyroid surgery. Current study evaluates the importance of localization methods in patients who underwent surgery for primary hyperparathyroidism.

Material and Methods: A total of 55 patients with primary hyperparathyrodism who applied to 6. Surgical Clinics of Ankara Numune Hospital between 1994 and 2009 were evaluated retrospectively. Pre- and post- surgical levels of total calcium, ionized calcium and parathormone (PTH) were compared. Sensitivities of ultrasonography (USG), scintigraphy and computerized tomography that were utilized as imaging methods were evaluated.

Results: The most common method in this study was USG. Scintigraphy which was utilized in 55 cases, was the most sensitive method. A lesion was detected in parathyroid glands in 43 cases and sensitivity of scintigraphy for detecting parathyroid lesions was 89.5%.

Conclusion: We concluded that utilization of imaging methods during preoperative period is justifed in patients with primary hyperprathyroidism both for determining the operative strategy and also for preventing possible complications related to reoperation. Scintigraphy and USG are the methods of choice. We also believe that the unilateral approach is the most appropriate method in cases with primary hyperparathyroidism in whon the lesion was localized with these methods.