[Parathyroidectomy under local anesthesia. First two cases in Lebanon and review of the literature]

The routine use of automated techniques to measure serum calcium levels have made disease states of the parathyroid gland a common endocrinologic problem. Because of the low sensitivity and specificity of early radiologic techniques to identify enlarged parathyroid glands, and because skilled endocrine surgeons report success rates of > 95% in identifying abnormal parathyroid glands, historically most parathyroid glands surgery consisted in a large cervicotomy under general anesthesia without preoperative localization. However, the development of sophisticated imaging techniques has now made it possible to identify the abnormal gland in a significant number of patients, leading some surgeons to choose unilateral neck exploration under local anesthesia for primary hyperparathyroidism. The success of the procedure is ascertained by measuring PTH peroperatively. We report the first two Lebanese patients, presenting with a solitary parathyroid adenoma, who underwent this easy, safe and cost-effective surgical technique.