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Intraoperative PTH Monitoring for Parathyroid Surgery

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Medical and Surgical Treatment of Parathyroid Diseases

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Abstract

Intraoperative PTH monitoring is now a commonly utilized tool in the surgical management of patients with sporadic primary hyperparathyroidism. Its use during parathyroidectomy guides the surgeon in operative decision making and is an often critical aspect of the surgery itself. The use of intraoperative PTH monitoring has several benefits over traditional bilateral neck exploration, including shorter operative times and hospital stays, and the reduced potential for complications. Most surgeons recommend using a greater than 50 % PTH drop criterion from the pre-incision PTH value to a 10 min post-excision PTH value for measuring operative success. Additionally, many surgeons recommend a post-excision PTH value that returns to the normal reference range. This criterion has improved accuracy in identifying parathyroid adenomas with reduction of unnecessary bilateral neck exploration. Further investigation is required into the utility and efficacy of intraoperative PTH monitoring for parathyroid disorders other than sporadic primary hyperparathyroidism.

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Author information

Authors and Affiliations

  1. Department of Otolaryngology, Georgetown University School of Medicine, Washington, DC, USA

    Jessica H. Maxwell M.D., M.P.H.

  2. Department of Otolaryngology-Head and Neck Surgery, Cancer Immunology Program, The Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA

    Robert L. Ferris M.D., Ph.D.

Authors
  1. Jessica H. Maxwell M.D., M.P.H.
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  2. Robert L. Ferris M.D., Ph.D.
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Correspondence to Robert L. Ferris M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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© 2017 Springer International Publishing Switzerland

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Maxwell, J.H., Ferris, R.L. (2017). Intraoperative PTH Monitoring for Parathyroid Surgery. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_22

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  • DOI: https://doi.org/10.1007/978-3-319-26794-4_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26792-0

  • Online ISBN: 978-3-319-26794-4

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