Surgical management strategies in patients with primary hyperparathroidism: Which technique in which patients?
Medical Principles and Practice. 2005; 14 (3): 194-8
in English
| IMEMR
| ID: emr-73528
ABSTRACT
This study was planned to investigate the efficacy of either 99mTc-sestamibi scan or ultrasonography in predicting the operative treatment in patients with primary hyperparathyroidism [PHPT]. Subjects and Method:
Thirty patients [25 female, 5 male; mean age 53 years] being operated for symptomatic primary PHPT were included in this study. Ultrasonography was used in 29 patients while 99mTc-sestamibi scintigraphy was done in 28 patients to localize the hyperfunctioning gland[s]. Standard bilateral neck exploration was done in 6 patients. Although unilateral intervention had been planned for 24 patients, bilateral intervention was performed in 9 of them. Sensitivity of 99mTc-sestamibi was 81%, while that of ultrasonography was 42%. 99mTc-sestamibi localization method led to misleading results in 10/28 [35.7%] patients. False-positive localization and accompanying thyroid pathologies played an important role in determining transition from unilateral to bilateral intervention. Our findings indicate that bilateral intervention remains a successful management option without prior localization in patients with PHPT especially in an endemic goiter region
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Index:
IMEMR (Eastern Mediterranean)
Main subject:
Radionuclide Imaging
/
Parathyroidectomy
/
Ultrasonography
/
Technetium Tc 99m Sestamibi
/
Disease Management
/
Hypercalcemia
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Med. Princ. Pract.
Year:
2005
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