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Article Dans Une Revue European Archives of Oto-Rhino-Laryngology Année : 2021

Surgical management of MILD hyperparathyroidism

Résumé

Introduction: There is no consensus for management of Mild primary hyperparathyroidism (MILD-pHP). Specific management has been suggested by some authors. We have compared the surgical management of the patients with MILD-pHP to those with Classic primary hyperparathyroidism (C-pHP) treated by surgery according to The Fourth International Workshop on pHP.Materials and methods: Data of 173 patients who underwent a parathyroidectomy were reviewed and retrospectively analysed. Management of 32 patients with MILD-pHPT (18.5%) patients were compared to that of 141 (81.5%) patients with C-pHPT.Results: MILD-pHP group was more often discovered after non-fractured osteoporosis (21.9% vs 7.1%, p = 0.02) and surgery for chondrocalcinosis was more often carried out (6.3% vs 0%, p = 0.03) in the MILD-pHP group. A Mini-Invasive Parathyroidectomy (MIP) was carried out in 81.3% of cases, and 87.5% of patients had a single adenoma. The rate of multiglandular pathology was not different. Same day discharge was significantly higher in MILD-pHP group (37.5% vs 17.7%, p = 0.01). Success was obtained in 87.5% in the MILD-pHP group, there was no significant difference with the C-pHP group (92.9%, p = 0.48). There was no significant difference in the imaging performances. Imaging discordance was observed in 18.8% of cases in MILD-pHP and 33.6% in C-pHP (p = 0.38) without correlation with surgical failure.Conclusion: This study suggests that, by selecting patients on the basis of concordant imaging and international recommendations, there is no difference in outcome between MILD-pHP and C-pHP treated surgically.
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Dates et versions

hal-03331717 , version 1 (30-09-2021)

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Adele Lecourt, Gwenaelle Creff, Paul Coudert, Olivier de Crouy Chanel, Pascal Guggenbuhl, et al.. Surgical management of MILD hyperparathyroidism. European Archives of Oto-Rhino-Laryngology, 2021, 278 (10), pp.3901-3910. ⟨10.1007/s00405-021-06953-9⟩. ⟨hal-03331717⟩
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