• Brendan C Stack, Neil S Tolley, Twyla B Bartel, John P Bilezikian, Donald Bodenner, Pauline Camacho, Jeremy P D T Cox, Henning Dralle, James E Jackson, John C Morris, Lisa Ann Orloff, Fausto Palazzo, John A Ridge, David Scott-Coombes, David L Steward, David J Terris, Geoffrey Thompson, and Gregory W Randolph.
• Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
• Head Neck. 2018 Aug 1; 40 (8): 1617-1629.

BackgroundRevision parathyroid is challenging due to possible diagnostic uncertainty as well as the technical challenges it can present.MethodsA multidisciplinary panel of distinguished experts from the American Head and Neck Society (AHNS) Endocrine Section, the British Association of Endocrine and Thyroid Surgeons (BAETS), and other invited experts have reviewed this topic with the purpose of making recommendations based on current best evidence. The literature was also reviewed on May 12, 2017. PubMed (1946-2017), Cochrane SR (2005-2017), CT databases (1997-2017), and Web of Science (1945-2017) were searched with the following strategy: revision and reoperative parathyroidectomy to ensure completeness.ResultsGuideline recommendations were made in 3 domains: preoperative evaluation, surgical management, and alternatives to surgery. Eleven guideline recommendations are proposed.ConclusionReoperative parathyroid surgery is best avoided if possible. Our literature search and subsequent recommendations found that these cases are best managed by experienced surgeons using precision preoperative localization, intraoperative parathyroid hormone (PTH), and the team approach.© 2018 Wiley Periodicals, Inc.

38 keywords...

hide…