Endocrine Abstracts

Introduction: Typically, there are 4 parathyroid glands in humans: 2 superior parathyroid glands usually located near the crico-thyroid joint, and 2 inferior parathyroid glands near the inferior pole of the thyroid gland. However they can be variable in number and location. Awareness of their potential location is crucial for the operating surgeon.

Objective: The purpose of this study is to describe parathyroid gland locations found during surgery.

Material and Methods: A retrospective study including 81 cases of hyperparathyroidism, operated between 2001 and 2021.

Results: The mean age was 53.2 years. Our study included 67 cases of secondary hyperparathyroidism and 14 cases of primary hyperparathyroidism. All patients, having secondary hyperparathyroidism, underwent subtotal 7/8 parathyroidectomy. In the majority of cases (80.6%), the parathyroid glands were found in their usual locations, without intraoperative challenges. Intrathymic localization was noted in 5 cases (thymectomy was performed in these cases). Two parathyroid glands were superposed in 5 cases. Parathyroid glands were located in the recurrent laryngeal nerve’s entry point into the larynx, in 3 cases. In cases of primary hyperparathyroidism, intraoperative difficulties were noted in 4 cases: prevertebral parathyroid gland (1 case), latero-tracheal parathyroid gland (2 cases) and parathyroid gland located between the trachea and the esophagus (1 case).

Conclusion: A knowledge of the unusual anatomic locations of parathyroid glands is crucial to operative success during parathyroid surgical exploration. Preoperative imaging can also helpful in the guidance of the surgical procedure.