[Diagnostic and surgical strategy in sporadic primary hyperparathyroidism].

The generalized use of phosphocalcic biological assays makes the discovery of sporadic primary hyperparathyroidism increasingly common. In 1989-1990, first-intention surgery was performed in 26 female patients. In all cases, an exploratory cervicotomy under cervical peridural anesthesia allowed discovering and treating a parathyroid lesion: adenoma, asymmetric or symmetric hyperplasia, cancer. We discuss: the circumstances of the clinical diagnosis and the biological criteria, the timeliness of preoperative radiological assessment, the surgical strategy advocated. In more than 90% of all cases, a cervicotomy for the exploration of all areas of parathyroid migration should allow curing primary hyperparathyroidism.