How is surgical care of PH?

-Surgical treatment should be offered to most patients with PH -The historical criterion-standard operative approach is complete neck exploration with identification of all parathyroid glands and removal of all abnormal glands -Approximately 85% of cases of PH are caused by a single adenoma -Therefore, most patients who undergo full neck exploration to evaluate all parathyroids endure some unnecessary dissection -Rather than explore all parathyroid glands, a newer technique, directed parathyroidectomy, has evolved -This technique relies on preop imaging studies to localize the abnormal gland The surgeon then removes only that gland, without visualizing the other glands