Hyperparathyroidism, with Particular Reference to Treatment

Abstract

The treatment of hyperparathyroidism has been discussed in considerable detail previously. Practically all the principles on which treatment is based were first set forth in a remarkably prescient paper by Churchill and Cope¹ in 1934. The surgical aspects were again discussed by Cope² in 1941 and by Rienhoff³ in 1950. The experience at the Mayo Clinic, based on the treatment of 63 patients, was reviewed in 1948⁴ and again after treatment of 112 patients, in 1953.⁵ Another review of the details of treatment does not seem warranted at this time, but some general impressions can well be considered. The increased experience of the present has provided a better understanding of the pathology of hyperparathyroidism and a far different conception of the anatomy of the parathyroids and of the frequency of mediastinal adenomas. Somewhat surprisingly, the surgical difficulties stressed in practically all previous papers have proved