Matthew M Smith1, William G Young2, Arthur M Carlin3, Tamer A Ghanem4. 1. Department of Otolaryngology, Henry Ford Hospital, Detroit, MI, USA. msmith29@hfhs.org. 2. Proliance Eastside ENT, Seattle, WA, USA. 3. Department of General Surgery, Henry Ford Hospital, Detroit, MI, USA. 4. Department of Otolaryngology, Henry Ford Hospital, Detroit, MI, USA.
Abstract
BACKGROUND: The pyriform sinus is a potential location for ectopic parathyroid tissue and we describe the use of trans-oral robotic to excise the ectopic tissue. METHODS: A 55-year-old female presented with primary hyperparathyroidism. 4D computed tomography and Sestimibi scan revealed a 1.2 × 0.7 cm mass in the left pyriform sinus. Using the da Vinci SI robot, a 1 cm hypopharyngeal incision was made with electrocautery in the left pyriform sinus and used to excise the mass. RESULTS: Ectopic mass was removed via trans-oral robotic approach and final pathology confirmed parathyroid tissue. Parathyroid hormone level dropped from 135.8 to 13.3 pg/ml 15 min after excision of the mass. CONCLUSION: Ectopic parathyroid tissue can present in many different areas of the neck, with the pyriform sinus being a potential location. The trans-oral robotic parathyroidectomy confers the advantage of the lack of an external incision for removal of ectopic parathyroid adenoma.
BACKGROUND: The pyriform sinus is a potential location for ectopic parathyroid tissue and we describe the use of trans-oral robotic to excise the ectopic tissue. METHODS: A 55-year-old female presented with primary hyperparathyroidism. 4D computed tomography and Sestimibi scan revealed a 1.2 × 0.7 cm mass in the left pyriform sinus. Using the da Vinci SI robot, a 1 cm hypopharyngeal incision was made with electrocautery in the left pyriform sinus and used to excise the mass. RESULTS: Ectopic mass was removed via trans-oral robotic approach and final pathology confirmed parathyroid tissue. Parathyroid hormone level dropped from 135.8 to 13.3 pg/ml 15 min after excision of the mass. CONCLUSION: Ectopic parathyroid tissue can present in many different areas of the neck, with the pyriform sinus being a potential location. The trans-oral robotic parathyroidectomy confers the advantage of the lack of an external incision for removal of ectopic parathyroid adenoma.
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