Abstract:
Hyperparathyroidism (HPT) is a common endocrine disorder.
The most common causes of primary HPT are parathyroid
gland hyperplasia and adenoma. HPT results in hypercalcaemia
which can result in serious complications
including peptic ulcer diathesis, acute pancreatitis, nephrocalcinosis,
nephrolithiasis and acute neurological disorders.
However many patients remain symptomless or their
complications are common disorders such as hypertension,
mild neuropsychiatric disorders or osteoporosis which are
not readily ascribed to hypercalcaemia. This latter group is
usually diagnosed unexpectedly from hypercalcaemia noted
on routine mass serum electrolyte measurements. Raised
serum parathyroid hormone (PTH) level indicates the cause
of hypercalaemia to be HPT. Hyperfunctioning enlarged
parathyroid glands can be identified by ultrasonography
and/or sestamibi scintigraphy. Surgery is the only definitive
treatment for primary HPT. Current practice for parathyroid
adenoma surgery is focused minimal access surgery after
preoperative localisation with ultrasonography/sestamibi
scintigraphy. Successful or complete adenoma excision is
confirmed by a rapid fall of serum PTH.1 Minimal access
parathyroid surgery affords patients a better quality of life
compared to traditional bilateral neck exploration.
