Use a Standard Nomenclature to Guide a Safe and Efficient Parathyroid Surgery

Abstract

Abstract

Introduction:

We have proposed a standard nomenclature system for parathyroid adenoma in 2009. ¹ This nomenclature offers an effective communication strategy between physicians when interpreting localization tests and facilitates systemic exploration in a difficult situation.^2–4 This video aims to help surgeons have a better understanding of this nomenclature system.

Materials and Methods:

We reviewed the A to H acronyms for this nomenclature. We used three-dimensional animation along with radiologic and intraoperative images to explain.

Results:

A stands for “adherent” to the upper pole of thyroid glands. B stands for “behind” the thyroid parenchyma in the tracheoesophageal groove. C stands for “close to the clavicle,” which is caudal than type B with the inferior pole as a border. D stands for “difficult,” which is close to the recurrent laryngeal nerve. E stands for “easy,” which is in a relatively superficial position near the lower pole. F stands for “fallen” into the thyrothymic ligament, which could be in the mediastinum. G stands for a “gauche,” an unusual truly intrathyroidal gland location. H stands for “halfway” between right and left, which is a retropharyngeal location. It is a rare location that is commonly seen in reoperative settings. ⁵ The most common positions are type B for superior glands and type E for inferior glands.^2,3

Conclusions:

The easy-to-remember A to H nomenclature covers all locations of parathyroid glands.^6–8 With this in mind, patient care team members can communicate better and provide more efficient care.

No competing financial interests exist.

Runtime of video: 7 mins