Some changing aspects of primary hyperparathyroidism

Ninety eight patients who underwent cervical exploration for primary hyperparathyroidism are reviewed. The detection of this condition in increasing numbers of patients, particularly those with minimal or no symptoms is confirmed. Initial exploration was successful in 92 cases using visual localisation with immediate frozen section examination of any presumed parathyroid tissue. The high incidence of solitary adenomata (84%) and low rate of recurrent hypercalcaemia support a "conservative" surgical approach as opposed to routine sub-total parathyroidectomy. The most common complication of surgery was hypocalcaemia, which is preventable by avoiding routine exhaustive exploration for, and unnecessary biopsy of, normal glands.