Outcomes of Surgical Management for Parathyroid Adenomas

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3439-3442. doi: 10.1007/s12070-023-04006-7. Epub 2023 Jun 27.

Abstract

Aim: Descriptive analysis of patients undergoing parathyroid adenoma surgery at a tertiary care hospital.

Methodology: Patients with parathyroid adenoma operated from January 2016 to December 2020. Serum calcium and PTH were used to establish the diagnosis. Ultrasonography (USG) studies localized the adenoma. NIH criteria was used for decision regarding surgery. Patients were analyzed with regards to pre operative localization, biochemical monitoring and other outcomes.

Results: Of the 15 eligible patients, all were symptomatic, with myalgia (34%) being the commonest symptom. Rome criteria confirmed the adequacy of the procedure by measuring intra operative drop in PTH. Average decrease in serum PTH level was 69.9% and serum calcium was 20.6% after excision of adenoma. The average size of excised adenoma was 2.5 cm. There were no post operative complications and all patients were normocalcemic on follow up.

Conclusion: Parathyroidectomy is a simple, safe and effective solution that reduces the morbidity of symptomatic primary hyperparathyroidism patients. Pre operative localization studies affirm the diagnosis and intra operative biochemical confirmation clinches the adequacy of resection.

Keywords: Hypercalcaemia; Parathyroid adenoma; Parathyroidectomy; Primary hyperparathyroidism.