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Head Neck. 2011 Dec;33(12):1715-8. doi: 10.1002/hed.21659. Epub 2011 Feb 14.

Split central venous sampling of parathyroid hormone: an adjunct to surgical exploration.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. maceri@usc.edu

Abstract

BACKGROUND:

Minimally invasive parathyroid surgery mandates preoperative localization of the adenoma for a targeted operative approach. This technique uses split internal jugular vein parathyroid hormone (PTH) samples to determine a gradient that then directs the surgical exploration.

METHODS:

Blood samples were drawn low in the neck from the jugular veins after the neck was opened. The p values for the difference in PTH between the right and left internal jugular veins were calculated with independent sample t tests.

RESULTS:

For left-sided adenomas, the left internal jugular vein mean was significantly higher than the right p = .001). For right-sided adenomas, the right internal jugular vein mean was significantly higher than the left (p = .004). In hyperplasia, there was no significant difference (p = .43).

CONCLUSIONS:

This study demonstrates the usefulness of split PTH internal jugular vein samples in patients in whom preoperative localization failed. Eighty percent of these patients with a gradient were treated with site-directed unilateral exploration.

PMID:
21322077
DOI:
10.1002/hed.21659
[Indexed for MEDLINE]

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