일차성 부갑상선기능항진증으로 수술적 치료를 받은 환자들에 대한 임상적 고찰

Background and Objectives: To evaluate the accuracy of ultrasound (US), computed tomography (CT) and ⁹⁹Tc sestamibi scan (MIBI) for preoperative localization of solitary parathyroid mass in patients with primary hyperparathyroidism and analyze our surgical outcomes. Materials and Methods: In a retrospective study of 57 consecutive patients with primary hyperparathyroidism, all patients underwent parathyroidectomy from Jan. 2003 through Dec. 2013. Patients were performed ultrasound, computed tomography and Technetium-99m ses-tamibi scan before surgery. We also reviewed serum calcium, serum parathyroid hormone (iPTH), associated symptoms and pathologic results through electronic medical records (EMR). Results: All 57 patients were enrolled and they had single solitary parathyroid mass. In final pathologic results, 45 patients had solitary parathyroid adenoma, 7 patients had nodular hyperplasia and 5 patients were diagnosed as parathyroid cancer. In adenoma and carcinoma as a single nodule, accuracy of US was 95.2% (40/42), CT was 91.7% (44/48), MIBI was 81.5% (31/38). The most common symptoms were general weakness and nausea. Interestingly, asymptomatic hypercalcemia, incidentaloma were over the half patients. Postoperative numbness was observed in 4 patients and they were treated with calcium supplementation but not persisted longer than 4th day postoperatively. Conclusions : Our results show that the combination of US, CT, MIBI has benefits for preoperative localization of parathyroid mass in primary hyperparathyroidism and parathyroidectomy was useful for patients with primary hyperparathyroidism. (J Clinical Otolaryngol 2017;28:205–210)