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KMID : 0361020060490080852
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Korean Journal of Otolaryngology - Head and Neck Surgery
2006 Volume.49 No. 8 p.852 ~ p.856
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A Case of Minimally Invasive Parathyroidectomy Using Intraoperative iPTH Monitoring to Ensure Operative Success
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Abstract
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The frequency of hyperparathyroidism has slowly increased recently with routine measurement of serum calcium and increasing awareness by the public of the disease. The success of parathyroid surgery depends on the identification and removal of all hyperactive parathyroid tissue. Advances in preoperative imaging, such as high resolution ultrasonography and Tc-99m sestamibi, plays a major role in the targeted operative approach that does not disturb the normal parathyroid glands. Tc 99m sestamibi scanning is generally viewed as the gold standard for preoperative parathyroid localization with high sensitivity and specificity, while the intraoperative measurement of intact parathyroid hormone (iPTH )provides the surgeon with a quantitative test that predicts the postoperative serum calcium level and can justify early closure or further exploration for hyperfunctioning parathyroid gland. Therefore, the combination of Tc-99m sestamibi and rapid intraoperative iPTH measurement enable minimally invasive techniques for multiple parathyroid lesions. The combination of Tc-99m sestamibi and intraoperative iPTH monitoring, indispensable for securing operative success, represents an accurate and effective diagnostic tools. The authors experienced a case that proved the combination of Tc-99m sestamibi and rapid intraoperative PTH monitoring useful and made a report with a review of literature.
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