title: Trans-oral robotic surgical excision of an ectopic parathyroid adenoma.
abstract: BACKGROUND
  The pyriform sinus is a potential location for ectopic parathyroid tissue and we describe the use of trans-oral robotic to excise the ectopic tissue.
  
  
  METHODS
  A 55-year-old female presented with primary hyperparathyroidism. 4D computed tomography and Sestimibi scan revealed a 1.2 × 0.7 cm mass in the left pyriform sinus. Using the da Vinci SI robot, a 1 cm hypopharyngeal incision was made with electrocautery in the left pyriform sinus and used to excise the mass.
  
  
  RESULTS
  Ectopic mass was removed via trans-oral robotic approach and final pathology confirmed parathyroid tissue. Parathyroid hormone level dropped from 135.8 to 13.3 pg/ml 15 min after excision of the mass.
  
  
  CONCLUSIONS
  Ectopic parathyroid tissue can present in many different areas of the neck, with the pyriform sinus being a potential location. The trans-oral robotic parathyroidectomy confers the advantage of the lack of an external incision for removal of ectopic parathyroid adenoma.
authors.affiliation: Department of Otolaryngology, Henry Ford Hospital, Detroit, MI, USA. msmith29@hfhs.org.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Smith
authors.affiliation: Proliance Eastside ENT, Seattle, WA, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Young
authors.affiliation: Department of General Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Carlin
authors.affiliation: Department of Otolaryngology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Tamer A
authors.initials: TA
authors.lastname: Ghanem
mesh_terms: D000236:Adenoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D010282:Parathyroid Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: Ectopic parathyroid; Parathyroid adenoma; Parathyroidectomy; Primary hyperparathyroidism; Trans-oral robotic surgery