The hypothesis that due to the high prevalence of solitary @entity652 and the accuracy of modern imaging techniques it should be possible to cure a considerable number of @entity1 by direct adenomectomy through a minimally invasive approach was tested in a consecutive series of 66 @entity1 with @entity459 . Preoperative parathyroid imaging consisted of a combination of (Doppler) ultrasound and spiral computed tomography with cine-loop reconstruction potentiality. If only one @entity3243 was identified preoperatively, a minimally invasive approach was advised. If more than one @entity652 was located, or when the imaging results were equivocal, the @entity1 was advised to undergo a conventional bilateral neck exploration. Sixty-six @entity1 (54 female, 12 male) with a median age of 60 years and a median serum @entity460 of 2.90 mmol L(-1) were studied. Fifty-one of these @entity1 underwent minimally invasive surgery, which was successful in 49 @entity1 , while conversion to conventional neck exploration was necessary in two @entity1 . Conventional neck exploration was chosen for the other 15 @entity1 . Six of these proved to have @entity66 or a retro-sternal @entity652 , while in nine @entity1 only one @entity3243 was found. All @entity1 became normocalcaemic postoperatively. Morbidity consisted of a transient unilateral vocal @entity912 in one @entity1 . These results support the original hypothesis: successful minimally invasive surgery was possible in 74% (49 of 66) of @entity1 , thus avoiding conventional neck exploration. This strategy further simplifies the operative treatment of @entity459 without loss of efficiency.

Successful minimally invasive surgery in XXXX after combined preoperative ultrasound and computed tomography imaging.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity459 :: ('MESH:D049950', 'Disease') :: ['primary hyperparathyroidism'] @entity66 :: ('MESH:D004194', 'Disease') :: ['multiglandular disease'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity3243 :: ('MESH:D010282', 'Disease') :: ['parathyroid adenoma'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma'] @entity912 :: ('MESH:D010243', 'Disease') :: ['cord paralysis']
@entity459 :: (MESH:D049950,Disease) :: ['primary hyperparathyroidism']
