Intraoperative parathyrin measurement in the management of parathyroid adenomectomy

We have monitored intraoperative parathyrin levels in 7 patients affected by parathyroid adenoma. We modified a commercially available immunoradiometric assay for intact parathyroid hormone (PTH) resulting in a 45 min turnaround time (TAT). The relationship between rapid PTH assay and the standard overnight method is excellent (r = 0.9983; p < 0,000001). Intraoperative sampling revealed a rapid PTH decline after surgical excision. In all patients serum PTH levels declined to a mean of 21% of the preoperative values. We suggest that the intraoperative measurement of PTH levels can complement surgical judgement and histopathologic information and has the potential for providing guidance regarding the extent of neck exploration necessary for determining surgical care.