Preoperative and perioperative localisation of primary hyperparathyreosis

The approach to surgery of primary hyperparathyreosis has changed radically over the last decade, advancing from bilateral neck exploration to unilateral approach. Surgery is guided by preoperative localisation studies, dominated by ultrasonography and scintigraphy, and by perioperative localisation studies with intraoperative parathormone in first place. Combining localisation techniques leads to therapeutical efficiency up to 98%. (author)