Question

In a patient with parathyroid adenoma, how do we confirm the removal of the correct gland after surgery?

• A. 50% reduction in PTH after 10 mins
• B. 50% reduction in PTH after 5 mins
• C. 25% reduction in PTH after 10 mins
• D. 25% reduction in PTH after 5 mins

Answer 1

The Correct Option is A

In the surgical treatment of a parathyroid adenoma, it is crucial to confirm the successful removal of the overactive gland. This confirmation helps ensure that the surgery was effectively performed to resolve hyperparathyroidism. The primary indicator used here is the level of parathyroid hormone (PTH) in the patient's blood after the excision of the gland.

The correct approach involves monitoring the PTH levels within a specific time frame after the adenoma removal. A significant drop in PTH levels indicates that the source of excess hormone production has been removed.

For accurate assessment, the most common protocol is:

• Measure the baseline PTH level before removal.
• Measure the PTH level again at intervals post-excision.

The cutoff for confirming a successful procedure is typically a:

50% reduction in PTH after 10 minutes

This is the standard timeframe and reduction percentage expected to confirm that the adequately functioning parathyroid glands remain in the body and the pathological source has been excised.

This approach leverages the short half-life of PTH (approximately 3-5 minutes), which allows for rapid changes in serum levels after gland removal. A 50% reduction within 10 minutes reflects a successful surgery, confirming the cessation of excessive hormone production.