title: Distribution of solitary parathyroid adenoma over the parathyroid glands and its surgical management.
abstract: OBJECTIVE
  To determine the distribution of solitary parathyroid adenoma over the parathyroid glands in a group of patients with primary hyperparathyroidism Design: A case-series.
  
  
  METHODS
  Departments of Surgery and Pathology at Shariati Hospital, Tehran, Iran, between the years 1981 and 2003.
  
  
  METHODS
  A retrospective review of surgery reports of 118 patients with primary hyperparathyroidism was performed. All of the patients had solitary parathyroid adenoma and the anatomical location of each adenoma was clearly defined during operation. Serum calcium, phosphorus and parathormone levels along with clinical characteristics were also included.
  
  
  RESULTS
  The distribution of adenomas over the superior and inferior parathyroid glands showed a significant higher incidence of adenoma in the lower parathyroids (p < 0.001). The right to left distribution of adenomas was not significant (p=0.4).
  
  
  CONCLUSIONS
  Surgical exploration for primary hyperparathyroidism should be initiated from the lower parathyroid glands provided that pre-operative localization scans are not helpful.
authors.affiliation: Endocrine Research Center, Vali-Asr Hospital.
authors.forename: Sepehr
authors.initials: S
authors.lastname: Hamidi
authors.forename: Anushiravan
authors.initials: A
authors.lastname: Hedayat
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Esfahanian
authors.forename: Nasser
authors.initials: N
authors.lastname: Kamalian