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Related Concept Videos

The Parathyroid Glands00:59

The Parathyroid Glands

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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  11. Investigating Intraoperative Parathyroid Hormone Criteria For Enhanced Accuracy And Surgical Success In Treating Primary Hyperparathyroidism: Results From Two Tertiary Referral Centres

Investigating intraoperative parathyroid hormone criteria for enhanced accuracy and surgical success in treating primary hyperparathyroidism: results from two tertiary referral centres

Eleonora Lori1, Loredana De Pasquale2, Alberto M Saibene3

  • 1Department of Surgery, 'Sapienza' University of Rome, Rome, Italy.

BJS Open
|June 13, 2025

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Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
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Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
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View abstract on PubMed

Summary
This summary is machine-generated.

Intraoperative parathyroid hormone (ioPTH) monitoring aids hyperparathyroidism surgery. A normal ioPTH range prevents persistence, while a >50% drop reduces unnecessary procedures. Combining both criteria offers the best surgical outcome prediction.

Area of Science:

  • Endocrinology
  • Surgical Oncology

Background:

  • Primary hyperparathyroidism is a common endocrine disorder requiring surgical treatment.
  • Intraoperative parathyroid hormone (ioPTH) measurement is crucial but its interpretation is debated.
  • The Miami criterion (>50% decrease in ioPTH 10 min post-removal) is evaluated for predicting surgical success and persistence rates.

Purpose of the Study:

  • To assess the efficacy of the Miami criterion in predicting surgical success for primary hyperparathyroidism.
  • To determine if meeting the Miami criterion reduces persistence rates.
  • To investigate the impact of achieving normal ioPTH levels, alone or combined with the Miami criterion, on surgical outcomes.

Main Methods:

  • Retrospective analysis of 380 patients with primary hyperparathyroidism undergoing surgery at two Italian centers.

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  • Univariate and multivariate analyses to identify predictors of persistence.
  • Assessment of diagnostic performance for ioPTH criteria individually and in combination.

    • Main Results:

    • Multivariate analysis confirmed both normal ioPTH range and >50% ioPTH decrease predict lower persistence.
    • The >50% reduction criterion showed higher sensitivity (95.0%) but lower specificity (45.0%) than normalization (81.1% sensitivity, 60.0% specificity).
    • Combining both criteria yielded the highest sensitivity (97.5%) and accuracy.

    Conclusions:

    • A fall in ioPTH to the normal range helps prevent persistence of hyperparathyroidism.
    • A >50% drop in ioPTH reduces unnecessary bilateral neck explorations.
    • Combining normal ioPTH levels with the >50% drop criterion provides the most accurate prediction of surgical outcomes.