Antoinette R Esce, Robert G Nicholas, Noah P Syme, Garth T Olson, Nathan H Boyd
{"title":"术中甲状旁腺激素动力学是可变的：体内分析","authors":"Antoinette R Esce, Robert G Nicholas, Noah P Syme, Garth T Olson, Nathan H Boyd","doi":"10.1177/00034894241298155","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Intraoperative parathyroid hormone (IOPTH) monitoring has become routine in parathyroid surgery to facilitate less invasive techniques to treat hyperparathyroidism. Despite this, little is known about in vivo IOPTH kinetics, which can greatly affect the reliability of its interpretation.</p><p><strong>Methods: </strong>A prospective cohort of patients undergoing routine parathyroidectomy was studied. During each case, IOPTH was measured frequently, during all key perioperative events. Qualitative, univariate, and multivariate analysis was performed to better understand the patterns of in vivo IOPTH kinetics.</p><p><strong>Results: </strong>The IOPTH increased from preoperative baseline in every case, but some patients had a rapid spike after gland manipulation while others had a more gradual increase. The IOPTH peak occurred prior to excision in almost every case. The IOPTH began to fall prior to excision, typically returning to preoperative baseline levels just before excision. The average in vivo half-life of parathyroid hormone (PTH) was 5.2 minutes.</p><p><strong>Conclusion: </strong>There is substantial variation in the in vivo IOPTH kinetics and more research is needed to understand predictors of kinetic patterns and PTH half-life during parathyroidectomy.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"142-147"},"PeriodicalIF":1.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intraoperative Parathyroid Hormone Kinetics are Variable: An In-Vivo Analysis.\",\"authors\":\"Antoinette R Esce, Robert G Nicholas, Noah P Syme, Garth T Olson, Nathan H Boyd\",\"doi\":\"10.1177/00034894241298155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Intraoperative parathyroid hormone (IOPTH) monitoring has become routine in parathyroid surgery to facilitate less invasive techniques to treat hyperparathyroidism. Despite this, little is known about in vivo IOPTH kinetics, which can greatly affect the reliability of its interpretation.</p><p><strong>Methods: </strong>A prospective cohort of patients undergoing routine parathyroidectomy was studied. During each case, IOPTH was measured frequently, during all key perioperative events. Qualitative, univariate, and multivariate analysis was performed to better understand the patterns of in vivo IOPTH kinetics.</p><p><strong>Results: </strong>The IOPTH increased from preoperative baseline in every case, but some patients had a rapid spike after gland manipulation while others had a more gradual increase. The IOPTH peak occurred prior to excision in almost every case. The IOPTH began to fall prior to excision, typically returning to preoperative baseline levels just before excision. The average in vivo half-life of parathyroid hormone (PTH) was 5.2 minutes.</p><p><strong>Conclusion: </strong>There is substantial variation in the in vivo IOPTH kinetics and more research is needed to understand predictors of kinetic patterns and PTH half-life during parathyroidectomy.</p>\",\"PeriodicalId\":50975,\"journal\":{\"name\":\"Annals of Otology Rhinology and Laryngology\",\"volume\":\" \",\"pages\":\"142-147\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Otology Rhinology and Laryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00034894241298155\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Otology Rhinology and Laryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00034894241298155","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Intraoperative Parathyroid Hormone Kinetics are Variable: An In-Vivo Analysis.
Objectives: Intraoperative parathyroid hormone (IOPTH) monitoring has become routine in parathyroid surgery to facilitate less invasive techniques to treat hyperparathyroidism. Despite this, little is known about in vivo IOPTH kinetics, which can greatly affect the reliability of its interpretation.
Methods: A prospective cohort of patients undergoing routine parathyroidectomy was studied. During each case, IOPTH was measured frequently, during all key perioperative events. Qualitative, univariate, and multivariate analysis was performed to better understand the patterns of in vivo IOPTH kinetics.
Results: The IOPTH increased from preoperative baseline in every case, but some patients had a rapid spike after gland manipulation while others had a more gradual increase. The IOPTH peak occurred prior to excision in almost every case. The IOPTH began to fall prior to excision, typically returning to preoperative baseline levels just before excision. The average in vivo half-life of parathyroid hormone (PTH) was 5.2 minutes.
Conclusion: There is substantial variation in the in vivo IOPTH kinetics and more research is needed to understand predictors of kinetic patterns and PTH half-life during parathyroidectomy.
期刊介绍：
The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.
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