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Preoperative Localization of Abnormal Parathyroid: Neck Massage versus Arteriography and Selective Venous Sampling

A. M. SPIEGEL, M.D.; J. L. DOPPMAN, M.D.; S. J. MARX, M.D.; M. F. BRENNAN, M.D.; E. M. BROWN, M.D.; R. W. DOWNS Jr., M.D.; D. G. GARDNER, M.D.; M. ATTIE, M.D.; and G. D. AURBACH, M.D.
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National Institutes of Health; Bethesda, Maryland

Ann Intern Med. 1978;89(6):935-936. doi:10.7326/0003-4819-89-6-935
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Preoperative localization is desirable in patients with primary hyperparathyroidism who have had previous neck surgery (1-3). Arteriography and selective venous sampling, the most effective localization techniques (3, 4), have several drawbacks including cost and lack of general availability. In 1969 Reiss and Canterbury reported (5) that measurement of serum parathyroid hormone (PTH) before and after massage of either side of the neck permitted preoperative localization of hyperfunctioning parathyroid glands. The advantages of neck massage, noninvasiveness and technical simplicity, prompted us to re-examine its efficacy as a parathyroid localization technique.

We studied 11 patients with primary hyperparathyroidism; informed consent was obtained.


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