Parathyroid Disease and Surgery

2.11.1 Discuss the embryology of the parathyroid glands. 

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2.11.2 Tell us about primary, secondary, tertiary and pseudo hyperparathyroidism.

2.11.3 Describe the clinical presentation of hyperparathyroidism.

2.11.4 List the differential diagnosis of hypercalcemia.

2.11.5 Indications for surgery in hyperparathyroidism.

2.11.6 Discuss the role of pre-operative vs. intra-operative localization studies. 

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Parathyroid%20Disease%20and%20Surgery/ParathyroidDiseaseandSurgery-Q6.jpg

Sofferman RA, Nathan MH, Fairbank JT, Foster RS Jr, Krag DN. Preoperative technetium Tc 99m sestamibi imaging. Paving the way to minimal-access parathyroid surgery. Arch Otolaryngol Head Neck Surg. 1996 Apr;122(4):369-74. PMID:8600920

Orloff LA. Methylene blue and sestamib~/images complementary tools for localizing parathyroids. Laryngoscope. 2001 Nov;111(11 Pt 1):1901-4. PMID:11801966

Sullivan DP, Scharf SC, Komisar A. Intraoperative gamma probe localization of parathyroid adenomas. Laryngoscope. 2001 May;111(5):912-7. PMID:11359177

2.11.7 Discuss the principles of surgical management of primary hyperparathyroidism.

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Sofferman RA. Surgical management of primary hyperparathyroidism: review of my experience at the University of Vermont. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):1056. PMID:9738826

2.11.8 Would you operate on an asymptomatic patient with hypercalcemia?

NIH conference. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement. Ann Intern Med. 1991 Apr 1;114(7):593-7. PMID:1900404

2.11.9 Discuss the indications for unilateral vs. bilateral parathyroid gland exploration.

Andersen PE, Cohen JI, Everts EC. Unilateral parathyroid exploration. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):1052-4. PMID:9738824

Khan A. Unilateral vs. bilateral parathyroid gland exploration: a continuing controversy. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):1055. PMID:9738825

2.11.10 Discuss recurrent or persistent hyperparathyroidism after surgery.