ABSTRACT
PURPOSE OF REVIEW: To summarize the current treatment approaches to parathyroid malignancy. RECENT FINDINGS: Recent advances in molecular biology are aiding the understanding of the pathogenesis of this condition, and imaging modalities are contributing to localization of the abnormal parathyroid tissue. SUMMARY: The treatment of parathyroid malignancy is overwhelmingly surgical, comprising an initial en bloc resection of the tumor and adjacent structures. The risk of tumor recurrence is high and may require several metastasis resections in order to control symptoms of hypercalcemia.
Subject(s)
Parathyroid Neoplasms/surgery , Parathyroidectomy , Humans , Hyperparathyroidism/etiology , Neoplasm Recurrence, Local , Parathyroid Neoplasms/complications , Parathyroid Neoplasms/diagnosis , Parathyroid Neoplasms/pathologyABSTRACT
Little has been published about the difficulties encountered during the insertion of osseointegrated implants for the attachment of bone anchored hearing aids (BAHA) and auricular prostheses in children. This study examines this issue in the first 51 children implanted at our centre. During surgery, the most common problem encountered was the presence of thin bone resulting in incomplete insertion of fixtures. Five fixtures had failed to integrate and six fixtures were lost in the long-term, however, only five children required revision surgery. The reason why few patients require revision was due to the judicious insertion of 'sleeper' fixtures. At follow-up, seven children required counselling for psychological problems. It is apparent from this study that osseointegrated implants in children are associated with difficulties, re-emphasizing that a paediatric osseointegration programme requires significant investment, and should only be undertaken by institutions that are committed to its success.