title: Surgical treatment of primary hyperparathyroidism: description of techniques and advances in the field.
abstract: Primary hyperparathyroidism is a disease commonly seen in patients above 60 years of age. It is the most common cause of asymptomatic or symptomatic hypercalcemia, usually found incidentally on routine check-ups. Surgical treatment is the only definitive treatment of choice in the symptomatic patient; however, it can also be employed in asymptomatic patients. First described in 1925, bilateral neck exploration is the gold standard of treatment for primary hyperparathyroidism. The recent interest in minimally invasive surgeries has led to better and improved techniques of neck exploration with improved cosmetic results and lesser chances of transient or permanent hypoparathyroidism due to inadvertent removal of normally functioning parathyroid tissue. These include unilateral neck explorations, minimally invasive parathyroidectomies and minimally invasive radio-guided parathyroidectomy. The intact parathyroid hormone assays have greatly added to the detection of normal and abnormal functioning glands, hence better surgical outcomes.
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Muhammad Adil Abbas
authors.initials: MA
authors.lastname: Khan
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Sadia
authors.initials: S
authors.lastname: Rafiq
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Sophocles
authors.initials: S
authors.lastname: Lanitis
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Farhan Arshad
authors.initials: FA
authors.lastname: Mirza
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Gwozdziewicz
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Ragheed
authors.initials: R
authors.lastname: Al-Mufti
authors.affiliation: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK.
authors.forename: Dimitri J
authors.initials: DJ
authors.lastname: Hadjiminas
keywords: Hyperparathyroidism; Minimally invasive surgical procedure; Neck dissection; Parathyroid hormone; Parathyroidectomy