European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 1, pp 267–272 | Cite as

Intraoperative parathyroid hormone testing in primary hyperparathyroidism surgery: time for giving up?

  • Paola Vincenza Sartori
  • Alberto Maria SaibeneEmail author
  • Ennio Leopaldi
  • Marco Boniardi
  • Edoardo Beretta
  • Samuele Colombo
  • Emanuela Morenghi
  • Juliana Pauna
  • Loredana De Pasquale
Short Communication



Intraoperative PTH testing (IOPTH) in treatment of primary hyperparathyroidism (PH) is debated. Some authors advise against IOPTH in patients with concordant preoperative imaging undergoing focused parathyroidectomy. This study aims to compare focused parathyroidectomy success rates with and without IOPTH in patients with concordant preoperative imaging.


Retrospective cohort study involving 599 consecutive patients underwent surgery for PH from 2012 to 2017. Patients with discordant preoperative imaging were excluded. 426 patients underwent focused parathyroidectomy (214 patients without IOPTH and 212 with IOPTH) and were considered for the statistical analysis. In case of insufficient IOPTH decay (less than 50%), a bilateral exploration was carried out.


The IOPTH group and the non-IOPTH group were similar for demographics and preoperative PTH and calcaemia. 413 patients were cured and disease persistence rates between groups were not significantly different (p > 0.05).


Although further testing and randomized-controlled trials are required to validate our findings, our data show that IOPTH does not seem to improve the outcome in patients with concordant preoperative imaging undergoing focused parathyroidectomy.


PTH level Primary hyperparathyroidism Parathyroid hormone Parathyroidectomy Minimally invasive surgery 



The authors did not receive any grant or financial support of sorts for this study. They have no financial disclosures to make.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interests pertaining this manuscript.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Paola Vincenza Sartori
    • 1
  • Alberto Maria Saibene
    • 2
    Email author
  • Ennio Leopaldi
    • 3
  • Marco Boniardi
    • 4
  • Edoardo Beretta
    • 5
  • Samuele Colombo
    • 6
  • Emanuela Morenghi
    • 7
  • Juliana Pauna
    • 4
  • Loredana De Pasquale
    • 2
  1. 1.Surgery DepartmentDesio HospitalDesioItaly
  2. 2.Thyroid and Parathyroid Surgery Service, Otolaryngology Unit, San Paolo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
  3. 3.Surgery DepartmentIGEA Private HospitalMilanItaly
  4. 4.General and Minimally Invasive Surgery DepartmentNiguarda HospitalMilanItaly
  5. 5.Endocrine Surgery UnitSan Raffaele HospitalMilanItaly
  6. 6.Endocrine Surgery CenterAuxologico InstituteMedaItaly
  7. 7.Biostatistics UnitHumanitas Clinical InstituteMilanItaly

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