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Parathyroid ectopia: development of a surgical algorithm based on operative findings

  • S Gunasekaran (a1), H Wallace (a1), C Snowden (a2), D Mikl (a2) and R J A England (a1)...



To study the incidence of ectopic parathyroid adenomata from a single surgical series, and to devise a surgical algorithm from the results to follow when an adenoma cannot initially be located.


A retrospective review was conducted of prospectively collected data. The study comprised all patients who underwent parathyroidectomy between June 2001 and February 2008 under the care of the senior author. A systematic surgical protocol was developed for locating ectopic superior and inferior parathyroid adenomata based on the order of incidence identified from the database.


Parathyroid ectopia occurs in approximately 10 per cent of hyperparathyroidism cases. It is more common in superior than inferior parathyroid glands. The most common superior location is the right retroesophageal position and the most common inferior location is within the left thymic remnant.


Prospective data collection and subsequent analysis can be used to develop a systematic surgical protocol to aid the localisation of ectopic enlarged parathyroid glands in the surgical management of hyperparathyroidism.


Corresponding author

Address for correspondence: Mr S Gunasekaran, Department of Otolaryngology and Head and Neck Surgery, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK E-mail:


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1Peeler, BB, Martin, WH, Sandler, MP, Goldstein, RE. Sestamibi parathyroid scanning and preoperative localization studies for patients with recurrent/persistent hyperparathyroidism or significant comorbid conditions: development of an optimal localization strategy. Am Surg 1997;63:3746
2Vail, AD, Coller, FC. The parathyroid glands: clinicopathologic correlation of parathyroid disease as found in 200 unselected autopsies. Mo Med 1967;64:234–8
3Kaplan, EL, Yashiro, T, Salti, GI. Primary hyperparathyroidism in the 1990s: choices of surgical procedures for this disease. Ann Surg 1992;215:300–17
4Ott, R, Lawrence, AM, Jorgensen, R, Calandra, D, Henkin, R, Barbato, A et al. Localization of ectopic parathyroid adenomas by the technetium-thallium subtraction scan. Am Surg 1985;51:344–8
5Randolph, GW, Urken, ML. Surgical management of primary hyperparathyroidism. In: Randolph, GW, ed. Surgery of the Thyroid and Parathyroid Glands. Philadelphia: Saunders Elsevier, 2003;509–15
6Wang, CA. Parathyroid re-exploration: a clinical and pathological study in 112 cases. Ann Surg 1977;186:140–5
7Phitayakorn, R, McHenry, CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 2006;191:418–23



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