INTRATHYROIDAL PARATHYROID-GLANDS CAN BE A CAUSE OF FAILED CERVICAL EXPLORATION FOR HYPERPARATHYROIDISM

BACKGROUND: The incidence of intrathyroidal parathyroid glands remains controversial. The purpose of this study was to determine the inciden ce in a series of patients with hyperparathyroidism. METHODS: Three hu ndred nine patients underwent parathyroidectomy. Patients were divided into two groups: uniglandular disease versus hyperplasia. RESULTS: Ei ghteen of 309 patients (6%) had abnormal intrathyroidal parathyroid gl ands. The incidence was 3% (7 of 222) in patients with uniglandular di sease versus 15% (11 of 73) in those with hyperplasia. With a mean fol low-up of 54 months, 12 patients are eucalcemic, 5 have persistent hyp ocalcemia, and 1 has recurrent hypercalcemia. There were no recurrent laryngeal nerve injuries. CONCLUSIONS: These data suggest that an intr athyroidal adenoma is an uncommon cause of failure, whereas abnormal i ntrathyroidal parathyroid tissue may be a more common cause of failure in patients with hyperplasia. (C) 1997 by Excerpta Medica, Inc.