{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T08:23:23Z","timestamp":1765268603740,"version":"build-2065373602"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T00:00:00Z","timestamp":1564444800000},"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":[[2019,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Tertiary hyperparathyroidism, an autonomous hyperproduction of parathyroid hormone (PTH), has a challenge in its treatment. This study asked whether the intraoperative PTH and calcium drop can confirm the resection of all parathyroid tissues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with planned data collection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>The study assessed patients with tertiary hyperparathyroidism who were treated at the Hospital of the State University of Campinas from 2007 to 2015. All patients underwent total parathyroidectomy with autotransplantation of parathyroid fragments. PTH and calcium were collected during the preoperative period; at 10, 20, and 240\u00a0minutes after resection of the glands; and at 1 year after the procedure. Data were analyzed by analysis of variance and logistic regression analysis with statistical values of <jats:italic>P<\/jats:italic> &lt;. 05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010five patients were assessed: 17 women (48.57%) and 18\u00a0men (51.43%). The percentage of PTH drop was statistically significant at all times, unlike the calcium analysis, but only PTH collected at 20\u00a0minutes was able to confirm the removal of all parathyroid tissues (<jats:italic>P<\/jats:italic> =. 029). Based on the receiver operating characteristic curve, the 71.2% drop obtained high sensitivity and specificity (<jats:italic>P<\/jats:italic> =. 028).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment success can be predicted by analyzing the decrease of intraoperative PTH and not by calcium. The 71.2% PTH drop at 20\u00a0minutes after parathyroidectomy had high sensitivity and specificity to predict surgical cure.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599819866819","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T05:14:22Z","timestamp":1564463662000},"page":"954-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pattern of Intraoperative Parathyroid Hormone and Calcium in the Treatment of Tertiary Hyperparathyroidism"],"prefix":"10.1002","volume":"161","author":[{"given":"Andr\u00e9 Lu\u00eds Maion","family":"Casarim","sequence":"first","affiliation":[{"name":"Head and Neck Surgery Service Department of Surgery Faculdade de Medicina de Jundia\u00ed Jundia\u00ed Brazil"},{"name":"Head and Neck Surgery Service Department of Surgery School of Medical Sciences Universidade Estadual de Campinas Campinas 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