Usefulness of Intraoperative Parathyroid Hormone Assay in Minimally Invasive Surgery.
10.3342/kjorl-hns.2009.52.5.426
- Author:
Ja Hyun LEE
1
;
Kyung Ray MOON
;
Hyun Ji KIM
;
Sung Min CHUNG
;
Han Su KIM
Author Information
1. Department of Otolaryngology and Head & Neck Surgery, School of Medicine, Ewha Womans University, Seoul, Korea. sevent@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Parathyroid;
Intraoperative parathyroid hormone
- MeSH:
Biopsy;
Humans;
Hyperparathyroidism, Primary;
Male;
Parathyroid Hormone;
Parathyroidectomy;
Retrospective Studies;
Technetium Tc 99m Sestamibi
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2009;52(5):426-430
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Intraoperative parathyroid hormone (PTH) assay has been proposed as an effective tool in minimally invasive parathyroidectomy. We evaluated its usefulness during minimally invasive parathyroidectomy. SUBJECTS AND METHOD: Ten patients (female 6, male 4) of primary hyperparathyroidism (8 single diseases, 2 multiple diseases) were analyzed retrospectively. We used computed tomography (CT) and 99mTc-Sestamibi (MIBI) scan for localization of parathyroid lesions preoperatively, and frozen biopsy and PTH assay at 10 (T-10), 20 (T-20) minutes after excision intraoperatively. We also compared the diagnostic sensitivity of CT and MIBI scan and intraoperative PTH. RESULTS: All patients were treated successfully and in single disease group, diagnostic sensitivity of CT, MIBI scan were 75% and 87.5%, and that of T-10 was 75% and T-20 was 100%. In multiple disease group, diagnostic sensitivity of CT, MIBI scan were 75%, 87.5%, and that of PTH was 80%. CONCLUSION: Intraoperative PTH assay improves cure rate in minimally invasive parathyroidectomy. It allowed intraoperative recognition of missed parathyroid lesions by preoperative imaging study.
