2687-0940Challenges in modern medicine2687-094010.52575/2687-0940-2023-46-1-92-99147SURGERY<strong>A Minimally Invasive Approach to Non-Standard Giant Initial Hyperparathyroidism</strong><strong>A Minimally Invasive Approach to Non-Standard Giant Initial Hyperparathyroidism</strong>YudinMaksim Yu.YudinMaksim Yu.doctor.judin@gmail.comKlimashevichAlexander V.KlimashevichAlexander V.klimashevich78@mail.ru202346100

Primary hyperparathyroidism is an endocrine disease characterized by excessive secretion of parathyroid hormone against the background of normal or elevated levels of calcium in the blood of extensive parathyroid glands. The main treatment for hyperparathyroidism is surgery. Because of the aspiration and often variant anatomy of the development of parathyroidectomy, a precise opening of the structure of many is required to reach the paraadenoma. In this case, the surrounding nervous and vascular diseases are often injuries. The recurrent laryngeal nerve serves as a landmark for identifying pathological parathyroid glands, since the superior parathyroid glands lie behind the pathway of the recurrent laryngeal nerve, while the inferior parathyroid glands lie in front of the passage of the recurrent laryngeal nerve.

Primary hyperparathyroidism is an endocrine disease characterized by excessive secretion of parathyroid hormone against the background of normal or elevated levels of calcium in the blood of extensive parathyroid glands. The main treatment for hyperparathyroidism is surgery. Because of the aspiration and often variant anatomy of the development of parathyroidectomy, a precise opening of the structure of many is required to reach the paraadenoma. In this case, the surrounding nervous and vascular diseases are often injuries. The recurrent laryngeal nerve serves as a landmark for identifying pathological parathyroid glands, since the superior parathyroid glands lie behind the pathway of the recurrent laryngeal nerve, while the inferior parathyroid glands lie in front of the passage of the recurrent laryngeal nerve.

primary hyperparathyroidismneuromonitoringrecurrent laryngeal nerveinjury of the external branch of the superior laryngeal nervealtered voice after parathyroidectomyprimary hyperparathyroidismneuromonitoringrecurrent laryngeal nerveinjury of the external branch of the superior laryngeal nervealtered voice after parathyroidectomyСписок литературыGolounina O.O., Runova G.E., Fadeev V.V., Pogorelova A.S., Boldy`reva G.V. 2019. Pervichny`j giperparatireoz s urovnem PTG v predelax referensny`x znachenij: sluchaj pozdnej diagnostiki u pacientki s recidiviruyushhim techeniem mochekamennoj bolezni [Primary hyperparathyroidism with pth values within the reference range: clinical case of a patient with recurrent nephrolithiasis]. Ozhirenie i metabolizm. 16 (3): 104&ndash;109. doi: 10.14341/omet10174Mokry`sheva N.G., Eremkina A.K., Mirnaya S.S., Krupinova Yu.A., Voronkova I.A., Kim I.V., Bel`cevich D.G., Kuzneczov N.S., Pigarova E.A., Rozhinskaya L.Ya., Degtyarev M.V., Egshatyan&nbsp;L.V., Rumyancev P.O., Andreeva E.N., Anciferov M.B., Markina N.V., Kryukova I.V., Karonova T.L., Luk`yanov S.V., Slepczov I.V., Chagaj N.B., Mel`nichenko G.A., Dedov I.I. 2021. Klinicheskie rekomendacii po pervichnomu giperparatireozu, kratkaya versiya [The clinical practice guidelines for primary hyperparathyroidism, short version]. Problemy` e`ndokrinologii. 4: 94&ndash;124.Akgun I.E., Unlu M.T., Aygun N., Kostek M., Uludag M. 2022. Contribution of intraoperative parathyroid hormone monitoring to the surgical success in minimal invasive parathyroidectomy. Front Surg. 9: 1024350. doi: 10.3389/fsurg.2022.1024350Baj J., Sitarz R., Łokaj M., Forma A., Czeczelewski M, Maani A., Garruti G. 2020. Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas. Molecules. 25 (7): 1724. doi: 10.3390/molecules25071724Dandurand K., Ali D.S., Khan A.A. 2021. Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management. Journal of Clinical Medicine. 10 (8): 1604. doi: 10.3390/jcm10081604Eligal S., Mekel M., Weinberger J.M., Neymark M., Hirshoren N., Mizrahi I., Eliashar R., Mazeh H. 2022. Minimally Invasive Parathyroidectomy: Can Intraoperative Parathyroid Hormone Monitoring be Omitted? World J. Surg. 46 (8): 1908&ndash;1914. doi: 10.1007/s00268-022-06537-6Ghani U., Assad S., Assad S. 2016. Role of Intraoperative Nerve Monitoring During Parathyroidectomy to Prevent Recurrent Laryngeal Nerve Injury. Cureus. 8 (11): e880. doi:10.7759/cureus.880Lu S., Gong M., Zha Y., Cui A., Tian W., Jiang X. 2021. Symptomatic primary hyperparathyroidism in a young woman presenting with multiple skeletal destructions: a case report and review of literature. BMC Endocr Disord. 21 (5). doi: 10.1186/s12902-020-00669-3Neves M.C., Santos R.O., Ohe M.N. 2022. Surgery for primary hyperparathyroidism. Arch Endocrinol Metab. 66 (5): 678&ndash;688. doi: 10.20945/2359-3997000000557Sbai A.A., Tsen A.A., Elayoubi F. 2022. Diagnostic and therapeutic determinants in parathyroid surgery: A retrospective cohort study. Ann. Med. Surg. (Lond). 82: 104751. doi: 10.1016/j.amsu.2022.104751Vaidya A., Curhan G.C., Paik J.M., Wang M., Taylor E.N. 2017. Body Size and the Risk of Primary Hyperparathyroidism in Women: A Cohort Study. J. Bone. Miner. Res. 32 (9): 1900&ndash;1906. doi:&nbsp;10.1002/jbmr.3168Walker M.D., Bilezikian J.P., Feingold K.R., Anawalt B., Boyce A., Chrousos G., de Herder W.W., Dhatariya K., Dungan K., Hershman J.M., Hofland J., Kalra S., Kaltsas G., Koch C., Kopp P., Korbonits M., Kovacs C.S., Kuohung W., Laferr&egrave;re B., Levy M., McGee E.A., McLachlan R., Morley J.E., New M., Purnell J., Sahay R., Singer F., Sperling M.A., Stratakis C.A., Trence D.L., Wilson D.P. 2021. Primary Hyperparathyroidism. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.Walker M.D., Silverberg S.J. 2018. Primary hyperparathyroidism. Nat Rev Endocrinol. 14 (2): 115&ndash;125. doi: 10.1038/nrendo.2017.104Wang Y., Liu J. 2020. Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature. J. Int. Med. Res. 48 (10): 300060520966484. doi: 10.1177/0300060520966484Wang Y., Ladie D.E. 2022. Parathyroidectomy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.