Due to the routine use of minimally invasive surgical techniques in patients with hyperparathyroidism, localizing parathyroid adenomas preoperatively has become extremely important. Parathyroid adenomas in an ectopic (i.e., intrathyroid) location are very difficult to identify during surgery unless preoperative imaging strongly suggests such a diagnosis, said presenter Dr. Matthew Heller of the University of Pittsburgh Medical Center.
Based on previous, largely anecdotal reports and a large population of such patients at a large referral center for endocrine surgery, the researchers decided to investigate the utility of ultrasound for identifying intrathyroid parathyroid adenomas in 144 patients identified from a prospective, multisurgeon database that included all patients undergoing parathyroidectomy from 1981 to 2011.
The study confirmed the several previous anecdotal reports of ultrasound's utility in identifying parathyroid adenomas prior to surgery, Heller said.
"Therefore, preoperative localization of intrathyroid parathyroid adenomas may thus determine if concurrent thyroid lobectomy will be necessary, obviate the need for wide and lengthy cervical exploration, and likely increase primary surgical success rates," he said.
