Challenges in Parathyroid Surgery

PROGRAM DESCRIPTION: This presentation will focus on challenging aspects of parathyroid surgery by offering technical points and management strategies important in optimizing surgical outcomes. Surgery for parathyroid disease has increasingly become more prevalent in the surgical practice of otolaryngologist/head and neck surgeons, both academic and community based. The spectrum of surgical parathyroid disease potentially encountered is broad and less straightforward than any one surgeon may have previously experienced. As such, it is important for the otolaryngologist/head & neck surgeon to be familiar with the complexities involved in surgical parathyroid disease, in order to successfully manage patients with these disorders. The goal of this discussion is to present challenging clinical/surgical scenarios dealing with unique aspects of parathyroid disease, together with management strategies and operative technical points which will provide guidance in achieving successful outcomes.
Discussion will be conducted in both a didactic and case-based format. Topics to be presented are as follows:
* Surgical findings which are discordant with intraoperative parathyroid hormone assessment
* Re-operative parathyroid exploration
* Surgical strategies for non-localizing parathyroid disease
* Surgical management of MEN 1 associated hyperparathyroidism
* Management of mediastinal parathyroid glands.
The presentation will focus on critical thinking, the development of management strategies and the description of operative technique(s) relevant to the topics addressed.
The presentation will be delivered by a panel of experienced head and neck surgeons whose clinical and surgical
practice is focused on high volume endocrine neck disorders. Each panelist is scholastically productive in the field of neck endocrine surgery and has extensive experience in surgical education.
At the conclusion of the presentation, participants will have gained insight into the management of complex parathyroid disorders which will optimize opportunities for successful treatment of their patients.

OUTCOME OBJECTIVE 1: Implement practical surgical management strategies for patients with primary hyperparathyroidism for whom localizing modalities are not successful.

OUTCOME OBJECTIVE 2: Demonstrate an understanding of how to intraoperatively manage patients in whom surgical findings are discordant with intraoperative parathyroid hormone results,

OUTCOME OBJECTIVE 3: Understand and be able to implement a rigorous and effective management strategy for patients requiring parathyroid re-exploration.

BACKGROUND STATEMENT: Extensive surgical experience is essential in achieving optimal outcomes in parathyroid surgery. Many practicing otolaryngologists do not possess this requisite nuanced experience. This discussion will enhance the ability of surgeons to manage patients with hyperparathyroidism.