Primary hyperparathyroidism.

PURPOSE OF REVIEW: This article reviews the diagnosis and treatment of primary hyperparathyroidism, including recent literature on the subject.

RECENT FINDINGS: Important recent advancements in the field of parathyroid disease include improvements in preoperative localization, the use of intraoperative parathyroid hormone monitoring, and the development of minimally invasive and videoscopic surgical techniques. Additionally, there has been significant interest in better understanding the clinical changes and presentation of sporadic primary hyperparathyroidism, including the assessment of neurocognitive symptoms before and after surgery. This has led to a change in the definition of the 'asymptomatic patient' and altered the criteria used to trigger surgical intervention.

SUMMARY: Although the cause of primary hyperparathyroidism is still poorly understood, surgical parathyroidectomy results in long-term cure in greater than 95% of cases. Improvements in our understanding of this disease continue to make diagnosis and treatment safer and more effective.