I have been performing head and neck surgery for 21 years as a faculty member at Ondokuz Mayıs University medical school. Especially i had an experience in thyroid and parathyroid surgery. I did a fellowship in Head and neck surgery for a year. Now I am head of otolaryngology head and neck surgery department

showing important point of open thyroidectomy and minimal invasive video asissted thyroidectomy

Description

This presentation will focus on the surgical management of patients with non-localizing or discordant-imaging parathyroid adenomas, one of the most challenging scenarios in endocrine surgery. Using operative video and case examples, the session will demonstrate practical strategies for successful exploration when preoperative localization studies such as ultrasound, sestamibi, or 4D-CT are inconclusive or discordant. Emphasis will be placed on systematic bilateral neck exploration, recognition of anatomic variants, intraoperative PTH monitoring, and identification of ectopic glands, including mediastinal and intrathyroidal locations. Decision-making algorithms and intraoperative navigation techniques will also be discussed.

Outcome Objectives

By the end of this session, participants will be able to:

1. Plan and execute surgery for parathyroid adenomas with non-concordant imaging findings.
2. Apply safe and systematic bilateral neck exploration techniques.
3. Utilize intraoperative PTH monitoring to confirm surgical success.
4. Identify and manage ectopic and difficult parathyroid lesions effectively.

Background

While most parathyroid adenomas can be accurately localized preoperatively, a subset of patients present with discordant or negative imaging results. These cases require advanced surgical expertise and meticulous exploration to achieve cure. Sharing real operative experience provides valuable insights into intraoperative decision-making and problem-solving in complex parathyroid surgery.