ABSTRACT

Patient Selection and Anticipated R esu lts ................................................................... 127 Optim al Timing Between Sestamibi and Operative Exploration .......................... 127 Use o f the Gam m a Probe in the Operating R o o m ..................................................... 130 Su m m ary ............................................................................................................................. 132

Primary hyperparathyroidism (HPTH) is the result of a single adenoma in 87-92% of all cases and is cured long-term following the removal of this one gland.1 Despite this fact, most surgeons continue to perform a complete bilateral neck exploration for patients with primary HPTH. The purpose o f this comprehensive dissection is to identify and even biopsy each gland so all hyperfunctional par­ athyroid tissue is identified and resected while normal glands are left behind. This conviction is a historical reflection o f the inability o f preoperative testing to accu­ rately distinguish those patients harboring a single diseased gland from the 8 to 13% with multiple adenomas or four gland hyperplasia.