Intraoperative Needle Aspiration Parathyroid Hormone Levels for Diagnosis of Abnormal Parathyroid Glands and Intraoperative Localization of Parathyroid Glands

Narin Ratanaprasert, Warut Pogsapich, Nilrat Wannasilp and Benjamas Kitnithee

Department of Otorhinolaryngology, Siriraj Hospital, Thailand

^*Correspondance to: Narin Ratanaprasert 

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Abstract:

Introduction: The success of parathyroidectomy depends on two important factors: accurate surgical recognition of abnormal parathyroid glands and pathological parathyroid confirmation of removed tissues. Needle aspiration for parathyroid hormone level has been applied to distinguish parathyroid from non-parathyroid tissues, with high accuracy. However, up until now there has been no cut-off value for the diagnosis of hyperfunction parathyroid glands.
Objective: To define the cut-off value of intraoperative needle aspiration parathyroid hormone level for the diagnosis of hyperfunctioning parathyroid glands and intraoperative localization of parathyroid glands.
Methods: A cross-sectional study was conducted in 35 hyperfunctioning parathyroid glands, and 35 normal parathyroid glands. Needle aspiration was performed during thyroid/parathyroid surgery. The aspirated tissues were washed with 5 mL of normal saline solution and immediately sent for parathyroid hormone analysis.
Results: The median parathyroid hormone levels were 2823 pg/mL, (IQR: 1871.1–5000) and 61.37 pg/mL, (IQR: 29.69–272.7) for the hyperfunctioning parathyroid and the normal parathyroid glands, respectively. The cut-off level of hyperfunctioning parathyroid gland was detected at 1050 pg/mL, with sensitivity and specificity more than 90%.
Conclusion: The cut-off value of intraoperative needle aspiration parathyroid hormone levels can differentiate not only parathyroid from non-parathyroid tissues but also hyperfunctioning parathyroid from normal glands. Whilst, when applied with other diagnostic tools, the high level of intraoperative needle aspirated parathyroid hormone can potentially yield useful information towards successful management of hyperparathyroidism. In our post-operative follow up period of 4 months to 2 years, there have been no recurrent or persistent hyperparathyroidism.

Keywords:

Parathyroid hormone; Parathyroid gland; Parathyroidectomy

Cite the Article:

Ratanaprasert N, Pogsapich W, Wannasilp N, Kitnithee B. Intraoperative Needle Aspiration Parathyroid Hormone Levels for Diagnosis of Abnormal Parathyroid Glands and Intraoperative Localization of Parathyroid Glands. World J Surg Surgical Res. 2018; 1: 1053.