Impact of Localization Studies and Clinical Scenario in Patients With Hyperparathyroidism Being Evaluated for Reoperative Neck Surgery

Abstract

Preoperative localization studies (LSs) for parathyroid reexploration, unlike for initial parathyroid surgery, are crucial for operative success. Numerous studies^1-10 in the literature have reported favorable outcomes of reoperative parathyroid surgery, as high as 97%, and have focused on the accuracy of LSs in directing surgeons where to explore. However, the success rates of curing patients with persistent or recurrent hyperparathyroidism (HPT) and the accuracy of LSs have been derived only from patients who do, in fact, undergo reoperative parathyroid surgery after LSs have successfully localized the site(s) of the abnormal parathyroid gland(s). On the other hand, those who do not meet the criteria for reexploration owing to nonlocalizing studies have been excluded from the analysis, skewing the actual success of reoperative parathyroid surgery and LSs in previous series.