Copyright ©The Author(s) 2016.
World J Surg Proced. Mar 28, 2016; 6(1): 1-7
Published online Mar 28, 2016. doi: 10.5412/wjsp.v6.i1.1
Figure 1
Figure 1 Intraoperative parathormone monitoring dynamics demonstrating a > 50% drop when compared to the pre-incision parathormone level using the Miami criterion. A: The drop of pre-excision PTH level suggests that the surgeon identified the hyperfunctioning gland during dissection reflected in the drop of PTH level; B: During dissection, manipulation of the abnormal gland may result in a release of PTH into the bloodstream, reflected by a surge in PTH level. It is important in this scenario to observe a drop in the PTH level on the subsequent 5 and 10 min samples from the higher pre-excision PTH level. IPM: Intraoperative parathormone monitoring; PTH: Parathormone.
Figure 2
Figure 2 Intraoperative parathormone monitoring dynamics demonstrating > 50% drop using the Miami criterion when more than one abnormal parathyroid gland is removed. When the PTH level fails to drop > 50% from either pre-incision or pre-excision levels, there should be a suspicion for MGD. IPM: Intraoperative parathormone monitoring; MGD: Multiglandular disease; PTH: Parathormone.