Diagnosis and Surgical Management of Primary Hyperparathyroidism

The content of this chapter includes a brief description of the primary hyperparathyroidism (PHPT) and its clinical variants. The standard of care approach to diagnosis and management of patients with PHPT is described in detail, including indications for surgical treatment, the most cost-effective and evidence-based preoperative radiological studies to detect parathyroid adenomas, preoperative management, and surgical approaches. Featured content of the chapter include description of localization techniques for ectopic parathyroid glands, intraoperative parathyroid hormone (PTH) monitoring, and approaches for treatment of PHPT during pregnancy. Summary of the most current evidence-based literature is presented to describe the prediction and treatment of postoperative hypocalcemia, short- and long-term follow-up after a surgical procedure, and the effect of the parathyroidectomy in patients with PHPT. The chapter is started with a case study along with a series of multiple choice questions and answers to further enhance learning and challenge an inquisitive mind.