title: Minimally invasive endoscopic selective parathyroidectomy.
abstract: Primary hyperparathyroidism is a common condition with surgery being the definitive treatment modality. Controversy exists over the extent of optimal neck exploration, whether unilateral or bilateral exploration should be performed, particularly since 85-90% of primary hyperparathyroidism results from single gland disease. Unilateral neck exploration is now considered to be adequate unless a definitive adenoma is not identified on ipsilateral exploration and where the serum intact Parathyroid Hormone (iPTH) level does not show a decline greater than 60% after removal of a suspected adenoma. It also avoids the potential risk of hypocalcaemia, recurrent laryngeal nerve injury along with extended anaesthesia and operative time and in-patient stay. With the advent of advanced imaging modalities and peri-operative localization techniques the hyper-functioning gland can be identified and minimally invasive procedures can be performed, limiting the neck exploration to only the abnormal gland. Here we would like to describe our procedure for a minimally invasive endoscopic selective parathyroidectomy, performed on five patients. We describe our standard setup, procedure and the outcomes.
authors: Department of Otolaryngology, Head & Neck Surgery, Aga Khan University, Karachi, Pakistan.
authors: Montasir
authors: M
authors: Junaid
authors: Zainul Abedeen
authors: ZA
authors: Sobani
authors: Maliha
authors: M
authors: Kazi
authors: Mumtaz Junaid
authors: MJ
authors: Khan
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy