Parathyroidectomy and Four-Gland Exploration for Hyperparathyroidism
Allison S. Letica-Kriegel, MD, MSc; Antonia E. Stephen, MD
Massachusetts General Hospital

Primary hyperparathyroidism is a common endocrinopathy. Surgery is the mainstay of treatment. Preoperative imaging is useful in localization of diseased glands and can allow for focal rather than four-gland exploration. Intraoperative adjuncts such as intraoperative parathyroid hormone (ioPTH) monitoring can be useful in select cases in determining the extent of parathyroid resection.