Freeman J B, Sherman B M, Mason E E
Arch Surg. 1976 Apr;111(4):359-64. doi: 10.1001/archsurg.1976.01360220055009.
Thirty-two neck explorations for hyperparathyroidism were done in 18 months. The indication for transcervical thymectomy was a failure to locate either inferior gland. Six of eight patients had adenomatous or hyperplastic glands located within or adjacent to the thymus. One infrathymic lesion was a parathyroid carcinoma and the other was a functioning parathyroid cyst. The abnormal parathyroid gland was not visible in any of these six patients until the thymus had been removed. Had this step been omitted, a sternotomy would probably have been required. Two patients had bilateral normal parathyroid glands within or deep to the thymus. Unless some normal parathyroid tissue has been identified and preserved, the indiscriminate use of transcervical thymectomy could result in the inadvertent excision of both inferior glands and possible iatrogenic hypoparathyroidism.
在18个月内对32例甲状旁腺功能亢进患者进行了颈部探查。经颈胸腺切除术的指征是未能找到下甲状旁腺。8例患者中有6例的腺瘤或增生性腺位于胸腺内或胸腺附近。1例胸腺下病变为甲状旁腺癌，另1例为功能性甲状旁腺囊肿。在切除胸腺之前，这6例患者中均未发现异常甲状旁腺。如果省略这一步骤，可能需要进行胸骨切开术。2例患者胸腺内或胸腺深部有双侧正常甲状旁腺。除非已识别并保留一些正常甲状旁腺组织，否则不加区分地进行经颈胸腺切除术可能会无意中切除双侧下甲状旁腺，并可能导致医源性甲状旁腺功能减退。
