ABSTRACT
The parathyroid glands were first described by Sir Richard Owen in a neck dissection of an Indian rhinoceros at the London Zoological Gardens in 1850. In 1905, MacCallum found that he could relieve postoperative tetany by the injection of parathyroid extract. The developmental embryology and surgical anatomy of the parathyroid glands are intimately linked, and knowledge of both is essential for successful surgical treatment of parathyroid disease. The inferior parathyroid gland and the thymus arise from the third pharyngeal pouch. The parathyroid glands play a central role in the regulation of serum calcium levels through the production of the active 84-amino-acid peptide, parathyroid hormone (PTH). Brown tumours of the long bones and associated subperiosteal bone reabsorption, distal tapering of the clavicles and the classical ‘salt and pepper’ erosions of the skull were typical findings. Treatment revolves around increasing renal excretion of calcium, reducing skeletal release of calcium and treatment of the underlying cause.
