PRIMARY
HYPERPARATHYROIDISM - USEFULNESS AND PRACTICAL ADVANTAGES OF INTRAOPERATIVE
PARATHORMONE MEASUREMENT (IOPTH)
Accurate
and reliable preoperative localization studies (typically neck ultrasonography
and parathyroid [Tc-99m sestamibi] scan) in association with IOPTH offers the
following advantages:
1.Limits
the extent of surgical manipulations/dissection, thereby limiting associated
surgical (iatrogenic) morbidity, mainly: (a) risk of injury to the recurrent
laryngeal nerve and (b) hypoparathyroidism due to dissection and/or biopsy of
normal parathyroid gland(-s). This advantage is of particular clinical
significance in recurrent/permanent hyperparathyroidism. In addition, it allows
a minimally invasive surgical approach (focused parathyroidectomy), resulting
in a better aesthetic outcome
2.Provides
a level of confidence that the hyperfunctioning parathyroid tissue has been
successfully removed, while leaving a functional remnant sufficient to preserve
normal parathyroid function and avoid postoperative hypocalcemia
(hypoparathyroidism)
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