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Clinical Challenges
September 1998

Unilateral Parathyroid Exploration

Author Affiliations


Arch Otolaryngol Head Neck Surg. 1998;124(9):1052-1054. doi:10.1001/archotol.124.9.1052

In performing parathyroidectomy for primary hyperparathyroidism, if on the first side there is 1 definite adenoma and 1 normal gland, the second side need not be explored.

The surgical treatment of primary hyperparathyroidism is one of the most gratifying procedures undertaken by the head and neck or endocrine surgeon. Rarely does one see such an immediate good result in surgery as the return to eucalcemia seen after a well-executed parathyroid gland exploration. On the other hand, a failed or poorly executed parathyroid gland exploration is an immensely frustrating experience. A failed exploration leaves the patient at risk for all the medical complications of hyperparathyroidism, subjects them to the risks of the initial exploration without any benefit, and leaves them subject to the increased risk of repeated exploration. In addition, unsuccessful exploration results in significant monetary cost1 and can shake the confidence of the surgeon in his/her ability.

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