{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:49:20Z","timestamp":1740138560873,"version":"3.37.3"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T00:00:00Z","timestamp":1503964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine the effect of preoperative parathyroid hormone (PTH) level on the extent of surgery and the accuracy of parathyroid imaging in primary hyperparathyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Final diagnosis of single\u2010gland adenoma and its location versus multigland disease was established in this retrospective cohort study. Positive predictive value, negative predictive value, and accuracy of imaging were analyzed in relation to preoperative PTH levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010seven percent of the 218 patients enrolled in the study underwent unilateral targeted operation and had a 97.9% (95% confidence interval: 95.8%\u2013100%) success rate. However, in patients with PTH &lt;65 pg\/mL, 28.6% had bilateral exploration compared to 10.3% in those with PTH \u226565 pg\/mL (<jats:italic>P<\/jats:italic>\u2009=\u2009.042). In patients with PTH &lt;65 pg\/mL, 7\/21 (33.3%) had inaccurate sestamibi findings compared to 24\/174 (13.8%) in patients with PTH \u226565 pg\/mL (<jats:italic>P<\/jats:italic>\u2009=\u2009.047).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Accuracy of sestamibi drops significantly, by threefold, in patients with mild primary hyperparathyroidism and PTH &lt;65 pg\/mL. Patients with PTH\u2009&lt;\u200965 pg\/mL have a 2.5\u2010fold higher rate of bilateral operation to identify the hypersecreting gland(s) compared to patients with PTH \u226565 pg\/mL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:1016\u20131021, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26699","type":"journal-article","created":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T15:24:35Z","timestamp":1504020275000},"page":"1016-1021","source":"Crossref","is-referenced-by-count":0,"title":["Minimally elevated preoperative parathyroid hormone level influences the management of primary hyperparathyroidism"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-2668","authenticated-orcid":false,"given":"Nader","family":"Sadeghi","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery George Washington University 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