Otolaryngologist-Head and Neck Surgeon-Performed Ultrasonography for Parathyroid Adenoma Localization

Objective: To demonstrate the efficacy of otolaryngologist-head and neck surgeon-performed ultrasonography (US) for the preoperative localization of parathyroid adenomas. Methods: A retrospective chart review of all patients evaluated by office-based US for the localization of surgery-proven parathyroid adenomas from October 2004 through February 2007. Results: A total of 29 patients underwent preoperative US localization. Twenty-three (79%) were females, and six (21%) were males. The age of patients ranged from 27 to 85 years of age. The size range of adenomas detected as measured by US was 0.5 to 2.7 cm. Pathology specimen measurements ranged from 0.3 to 3.4 cm. A total of 30 parathyroid adenomas were found. US identified 90% of the parathyroid adenomas to the correct side, left or right. In addition, US localized the parathyroid adenomas to the correct quadrant, superior or inferior, 83% of the time. Challenges in accurate localization were associated with patient obesity, presence of thyroid carcinoma, and multinodular thyroid disease. For comparison, sestamibi scans performed on the same patients localized the parathyroid adenoma to the correct side only 71% of the time and to the correct quadrant 61% of the time. Conclusions: Otolaryngologist-head and neck surgeon-performed US can accurately identify the location of parathyroid adenomas and is a useful tool for preoperative planning.