Abstract

Surgery of parathyroid revolves around the management of hyperparathyroidism (HPT). In most cases, occurrence is sporadic rather than familial, and 80-85% of cases of sporadic primary HPT are caused by a solitary parathyroid adenoma. The diagnosis is made by hypercalcaemia with an inappropriately elevated parathyroid hormone (PTH) level and a 24-hour urine calcium excretion level that is normal or high. Improved assay for PTH has led to earlier detection of HPT and has been responsible for the apparent increase in the prevalence of the disorder. An improvement in preoperative localisation studies as well as the development of a rapid intraoperative PTH assay has changed the approach to parathyroid surgery in the last two decades. This article provides a brief overview of management of primary HPT.

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