Three-Dimensional Computed Tomography Reconstruction for Revision Parathyroidectomy.

A 57-year-old man presented with persistent hyperparathyroidism following primary parathyroidectomy. A four-dimensional computed tomography scan with three-dimensional reconstruction showed two parathyroid glands (one right and one left) and anatomic variation from previous surgery. Revision surgery was performed revealing the parathyroid glands as expected from the preoperative three-dimensional reconstruction. After surgery, the patient recovered well, and preoperative symptoms resolved. The use of three-dimensional computed tomography reconstruction provided accurate localization of the parathyroid glands and surrounding anatomic structures. This resulted in decreased preoperative planning cost, operative time, and estimated blood loss typical for patients who have multiple preoperative imaging studies.