Ranganath Rohit, Shaear Mohammad, Razavi Christopher R, Pace-Asciak Pia, Russell Jonathon O, Tufano Ralph P
Department of General Surgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Division of Head and Neck Endocrine Surgery, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
World J Otorhinolaryngol Head Neck Surg. 2020 Jun 30;6(3):155-160. doi: 10.1016/j.wjorl.2020.01.012. eCollection 2020 Sep.
Advances in imaging for preoperative localization have propelled the widespread adoption of minimally invasive/focused parathyroidectomy in primary hyperparathyroidism. Though it is performed through a relatively small incision, studies have shown that the presence of a neck scar increases attentional bias towards the neck resulting in compromised quality of life. Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) eliminates a neck scar. While indications for TOEPVA are the same as that of minimally invasive open parathyroidectomy, confident preoperative localization of the parathyroid with a surgeon performed ultrasound along with concordant localization with SPECT CT is an essential prerequisite before offering patients this approach for parathyroidectomy. Early data has demonstrated the feasibility and safety of this approach.
术前定位成像技术的进步推动了微创/聚焦甲状旁腺切除术在原发性甲状旁腺功能亢进症中的广泛应用。尽管该手术通过相对较小的切口进行，但研究表明，颈部瘢痕的存在会增加对颈部的注意力偏差，从而导致生活质量下降。经口内镜甲状旁腺切除前庭入路（TOEPVA）消除了颈部瘢痕。虽然TOEPVA的适应症与微创开放性甲状旁腺切除术相同，但在为患者提供这种甲状旁腺切除方法之前，外科医生进行的超声对甲状旁腺进行可靠的术前定位以及与SPECT CT的一致定位是必不可少的前提条件。早期数据已证明了这种方法的可行性和安全性。
