Intraoperative parathyroid hormone monitoring to determine long-term success of total parathyroidectomy for secondary hyperparathyroidism
Article first published online: 19 MAY 2010
Copyright © 2010 Wiley Periodicals, Inc.
Head & Neck
Volume 33, Issue 3, pages 293–296, March 2011
How to Cite
Moor, J. W., Roberts, S., Atkin, S. L. and England, R. J. A. (2011), Intraoperative parathyroid hormone monitoring to determine long-term success of total parathyroidectomy for secondary hyperparathyroidism. Head Neck, 33: 293–296. doi: 10.1002/hed.21441
- Issue published online: 11 FEB 2011
- Article first published online: 19 MAY 2010
- Manuscript Accepted: 22 FEB 2010
- Manuscript Revised: 31 JAN 2010
- Manuscript Received: 20 OCT 2009
- secondary hyperparathyroidism;
- intraoperative monitoring;
- parathyroid hormone;
- follow-up studies
Use of intraoperative parathyroid hormone (ioPTH) monitoring during total parathyroidectomy for secondary hyperparathyroidism is common, although its ability to predict long-term normoparathyroid state is not known.
Prospective evaluation of 57 consecutive patients undergoing total parathyroidectomy for renal hyperparathyroidism with ioPTH monitoring and follow-up PTH assays were used to categorize the patients into 3 groups: success, adequate biochemical control, and failure.
There was no statistically significant difference in percentage reduction of ioPTH between the 3 groups (p = .07), although there was a moderate negative correlation between percentage reduction of ioPTH and percentage reduction of PTH at follow-up (R = 0.57).
When used under current guidelines, ioPTH monitoring is of no use in predicting long-term cure for these patients because it does not predict success. Patients that undergo total parathyroidectomy are required to have long-term calcium and PTH assay follow-up because normoparathyroidism cannot be assumed. Using the regression equation calculated, success may be predicted for future patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2010