Noah Syme1, Garth Olson2, Michael F Spafford2, Nathan Boyd2. 1. University of Iowa Hospital, Department of Otolaryngology, USA. Electronic address: nsyme@salud.unm.edu. 2. University of New Mexico Hospital Department of Surgery, Division of Otolaryngology, USA.
Abstract
INTRODUCTION: This study demonstrates the effectiveness of a microvascular clamp to simulate parathyroid adenoma excision with respect to intraoperative parathyroid hormone (ioPTH) changes in vivo. METHODS: Cases in which microvascular clamps were employed intraoperatively in conjunction with intraoperative parathyroid hormone(ioPTH) assays were reviewed. ioPTH values were recorded throughout these procedures to assess the efficacy and reversibility of tissue ischemia using microvascular clamps. RESULTS: Application of a microvascular clamp across the vascular pedicle of a parathyroid adenoma resulted in a significant ioPTH drop in 95% of cases (N = 20). Removal of the clamp resulted in complete or partial rebound of ioPTH in 90% of cases (N = 20). CONCLUSION: The use of a microvascular clamp to temporarily occlude a parathyroid gland's vascular pedicle is an effective simulation of gland excision with respect to ioPTH changes. Rebound of ioPTH levels after clamp removal demonstrates that this technique is generally reversible. LEVEL OF EVIDENCE: 2b, Retrospective cohort study. Published by Elsevier Inc.
INTRODUCTION: This study demonstrates the effectiveness of a microvascular clamp to simulate parathyroid adenoma excision with respect to intraoperative parathyroid hormone (ioPTH) changes in vivo. METHODS: Cases in which microvascular clamps were employed intraoperatively in conjunction with intraoperative parathyroid hormone(ioPTH) assays were reviewed. ioPTH values were recorded throughout these procedures to assess the efficacy and reversibility of tissue ischemia using microvascular clamps. RESULTS: Application of a microvascular clamp across the vascular pedicle of a parathyroid adenoma resulted in a significant ioPTH drop in 95% of cases (N = 20). Removal of the clamp resulted in complete or partial rebound of ioPTH in 90% of cases (N = 20). CONCLUSION: The use of a microvascular clamp to temporarily occlude a parathyroid gland's vascular pedicle is an effective simulation of gland excision with respect to ioPTH changes. Rebound of ioPTH levels after clamp removal demonstrates that this technique is generally reversible. LEVEL OF EVIDENCE: 2b, Retrospective cohort study. Published by Elsevier Inc.