Historical Perspectives on Parathyroid Surgery

Abstract

The field of parathyroid surgery is rich in history. It begins with an obscure publication by a Swedish medical student noting a distinct anatomic entity in the neck adjacent to the thyroid gland; these tiny glands would come to be known as the parathyroid glands. This was followed by the subsequent discovery of their role in calcium metabolism, once the devastating effects of hyperparathyroidism on the bones and kidneys were recognized. The first neck explorations with identification and removal of parathyroid adenomas took place in the early twentieth century. Following the initial parathyroid operations in the United States and Europe, the mid-twentieth century was dominated by extensive investigation into calcium metabolism and the effects of parathyroid hormone and by refinement of techniques in parathyroid surgery. In more recent years, the introduction of sophisticated localization studies and minimally invasive parathyroid operations continues to inspire progress in this unique and fascinating field. In this review, the sequence of events starting with the anatomic recognition of the parathyroid glands and ending with the most recent developments and advances in parathyroid surgery are described.