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Efficacy of surgeon-performed, intra-operative ultrasound scan for localisation of parathyroid adenomas in patients with primary hyperparathyroidism

Published online by Cambridge University Press:  16 December 2022

A Habib Open the ORCID record for A Habib [Opens in a new window] ,
E Molena ,
C Snowden  and
J England
A Habib*
Affiliation:
Department of ENT, Hull University Hospitals NHS Trust, UK
E Molena
Affiliation:
Department of ENT, Hull University Hospitals NHS Trust, UK
C Snowden
Affiliation:
Department of Anaesthesia, Hull University Hospitals NHS Trust, UK
J England
Affiliation:
Department of ENT, Hull University Hospitals NHS Trust, UK
*
Corresponding author: A Habib, Bradford Royal Infirmary, Duckworth Ln, Bradford BD9 6RJ, UK Email: ayaazhabib@yahoo.co.uk
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Abstract

Background

In the UK, guidance recommends ultrasound scanning alone or in combination with sestamibi scintigraphy to guide surgery in patients with primary hyperparathyroidism. If an adenoma is localised on imaging, this can facilitate targeted or minimally invasive surgery. Surgeon-performed ultrasound scan on the operating table benefits from being performed on an anaesthetised patient with optimal positioning. The aim of this study was to investigate the efficacy of intra-operative, blinded, surgeon-performed ultrasound scan in localisation of parathyroid adenomas.

Methods

Prospective data were collected on consecutive patients undergoing surgery for primary hyperparathyroidism at a single tertiary centre from November 2019 to June 2021. Patients underwent blinded, surgeon-performed ultrasound scan under general anaesthesia immediately prior to surgery. Localisation results from pre-operative imaging and surgeon-performed ultrasound scan were then compared with the intra-operative findings.

Results

Forty-nine patients underwent surgery and were found to have single-gland disease. Sestamibi scintigraphy, radiologist-performed ultrasound scan and surgeon-performed ultrasound scan had sensitivities of 59.4, 43.75 and 73.8 per cent, respectively. Surgeon-performed ultrasound scan had a statistically significantly increased sensitivity compared with radiologist-performed ultrasound (p < 0.05).

Conclusion

Intra-operative, surgeon-performed ultrasound scan is effective in localising parathyroid adenomas and may be a useful adjunct to facilitate minimally invasive parathyroid surgery.

Keywords

ParathyroidectomyUltrasonographyProspective Studies
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 8 , August 2023 , pp. 910 - 913
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr A Habib takes responsibility for the integrity of the content of the paper

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