Reoperative Parathyroidectomy

Reoperative surgery for hyperparathyroidism is associated with increased incidence of complications including vocal cord paralysis, permanent hypoparathyroidism, and persistent hypercalcemia. Surgical re-exploration should consist of symptomatic or low-risk patients. The use of nuclear medicine imaging, ultrasound, and high-resolution CT and MRI may aid in surgical planning. Knowledge of potentialectopic locations and a well-planned surgical approach from lateral to medial is critical, however, in ensuring adequate resection, which may be verified by intraoperative parathyroid hormone monitoring.