Bilateral Neck Exploration for Primary Hyperparathyroidism
摘要
Bilateral (or four-gland) exploration remains an important component of parathyroid surgery. Adjuncts such as intraoperative PTH, imaging studies, and radioguided surgical approaches can help guide parathyroidectomy during bilateral exploration. Multigland disease requires identification of all parathyroid tissue and referral for genetic testing for familial disorders (MEN1, MEN2A). Parathyroid surgeons should have a systematic approach to the “missing parathyroid gland” based on the embryology of pharyngeal pouch migration.