{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:43:26Z","timestamp":1761007406490,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,11,10]],"date-time":"2011-11-10T00:00:00Z","timestamp":1320883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to compare the clinical effectiveness of surgery with calcimimetics as treatment strategies for managing the biochemical abnormalities that characterize secondary hyperparathyroidism (2HPTH), resistant to optimal conventional therapy in patients with end\u2010stage renal failure (ESRF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A historical cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Maxillofacial Department, Morriston Hospital, Swansea, United Kingdom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Fifty\u2010four patients with 2HPTH resistant to optimal conventional medical management were studied. One cohort of 20 patients was treated with surgical parathyroidectomy, the other cohort of 34 patients with cinacalcet. Serum parathyroid hormone (PTH) and bone profile were measured before and at monthly intervals after intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both cohorts were comparable in their demographic profile, pretreatment comorbidities, baseline PTH, and bone profile. In all 20 surgical patients, the 1\u2010week postoperative PTH had decreased by 97% (<jats:italic>P<\/jats:italic> &lt;. 001); in the medical cohort after 4\u00a0months of daily cinacalcet, the PTH decreased by 48% (<jats:italic>P<\/jats:italic> &lt;. 001) from baseline. This reduction was maintained at 18\u00a0months. In all but 1 surgical patient, alkaline phosphatase (ALP) decreased to normal levels, whereas on cinacalcet, there was no statistically significant reduction. Patients who underwent parathyroidectomy had a more significant decrease in PTH (<jats:italic>P<\/jats:italic> &lt;. 001) and ALP (<jats:italic>P<\/jats:italic> &lt;. 0014) than did patients on cinacalcet therapy. All patients managed surgically who complained of preoperative symptoms of pruritis and bone pain expressed complete resolution or significant improvement after parathyroidectomy (<jats:italic>P<\/jats:italic> &lt;. 001, <jats:italic>P<\/jats:italic> &lt;. 003, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgery was superior to \u201cmedical\u201d parathyroidectomy in controlling PTH and ALP.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811428272","type":"journal-article","created":{"date-parts":[[2011,11,11]],"date-time":"2011-11-11T01:32:19Z","timestamp":1320975139000},"page":"220-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Surgical Parathyroidectomy versus Cinacalcet Therapy"],"prefix":"10.1002","volume":"146","author":[{"given":"Assia","family":"Ghani","sequence":"first","affiliation":[{"name":"Maxillofacial Department Morriston Hospital Swansea United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prudence","family":"Baxter","sequence":"additional","affiliation":[{"name":"Maxillofacial Department Morriston Hospital Swansea United 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