EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS

Bilal Turan; Rasih Yazkan

doi:10.17343/sdutfd.492994

EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS

Öz

ÖZET

Ektopik paratiroid bezleri, gözden kaçırıldıklarında, persistan veya rekürren hiperparatiroidizmin ortak bir etiyolojisini oluştururlar. Ektopik paratiroid bezleri, embriyogenez sürecinde anormal göçten kaynaklanır ve başarılı bir identifikasyon olmaması paratiroid cerrahisinde başarı eksikliğine neden olabilir. Ektopik inferior paratiroidler anterior mediastende, timus veya tiroid bezinde en sık görülürken, ektopik superior paratiroidler için en sık görülen pozisyon trakeoözofageal oluk ve retro özofageal bölgedir. Boyun ultrasonografisi, 99mTc Sestamibi taraması ve tek foton emisyonlu bilgisayarlı tomografi (SPECT) veya CT (SPECT / CT) ektopik paratiroidlerin tanısal doğruluğunu arttıran görüntüleme yöntemleridir. Paratiroid dokusu için şüpheli bir lezyonun ince iğne aspirasyon sitolojisi ve aspire edilen materyalin paratiroid hormonu ölçümü ektopik bezlerin preoperatif lokalizasyonuna yardımcı olur. Cerrahi inceleme için yaygın alanlar, üst paratiroidler için üst tiroid kutbu, üst tiroid vasküler yapıları ve servikal özofagus, inferior paratiroidler için karotis arter bifurkasyonu ve timustur. Radyografik olarak başarılı lokalizasyondan sonra minimal invaziv paratiroidektomi, postoperatif hızlı parathormon ölçümü ile desteklenerek ektopik paratiroid adenomu olan hastalarda cerrahi sonuçları önemli ölçüde artırmaktadır.

Anahtar kelimeler: Ektopik paratiroid, parathormon, primer hiperparatiroidizm

ABSTRACT

Ectopic parathyroid glands, when missed, form a common etiology of persistent or recurrent hyperparathyroidism. Ectopic parathyroid glands originate from abnormal migration in the embryogenesis process and lack of a successful identification may lead to a lack of success in parathyroid surgery. While ectopic inferior parathyroids are most common in the anterior mediastinum, thymus or thyroid gland, the most common position for ectopic superior parathyroids is the tracheoesophageal groove and the retro esophageal region. Neck ultrasonography, 99mTc Sestamibi scanning and single-photon emission computed tomography (SPECT) or CT (SPECT / CT) are imaging modalities that increase the diagnostic accuracy of ectopic parathyroids. The fine needle aspiration cytology of the suspected lesion for parathyroid tissue and the parathyroid hormone measurement of the aspirated material help preoperative localization of ectopic glands. Common areas for surgery are upper thyroid pole, upper thyroid vascular structures and cervical esophagus for upper parathyroids and bifurcation of the carotid artery and thymus for inferior parathyroids. After radiographic successful localization, minimally invasive parathyroidectomy is supported by postoperative rapid parathyroid hormone measurement, which significantly increases surgical outcomes in patients with ectopic parathyroid adenoma.

Key words: Ectopic parathyroid, parathormone, primary hyperparathyroidism

Anahtar Kelimeler

Anahtar kelimeler: Ektopik paratiroid,parathormon

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Cerrahi

Bölüm

Derleme

Yazarlar

Bilal Turan ^*
0000-0003-1665-3607
Türkiye

Rasih Yazkan
Türkiye

Yayımlanma Tarihi

1 Haziran 2019

Gönderilme Tarihi

6 Aralık 2018

Kabul Tarihi

27 Aralık 2018

Yayımlandığı Sayı

Yıl 2019 Cilt: 26 Sayı: 2

DOI

https://doi.org/10.17343/sdutfd.492994

IZ

https://izlik.org/JA47AB34FC

Kaynak Göster

RIS / Bibtex

APA

Turan, B., & Yazkan, R. (2019). EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS. Medical Journal of Süleyman Demirel University, 26(2), 221-227. https://doi.org/10.17343/sdutfd.492994

AMA

1.Turan B, Yazkan R. EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS. SDÜ Tıp Fak Derg. 2019;26(2):221-227. doi:10.17343/sdutfd.492994

Chicago

Turan, Bilal, ve Rasih Yazkan. 2019. “EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS”. Medical Journal of Süleyman Demirel University 26 (2): 221-27. https://doi.org/10.17343/sdutfd.492994.

EndNote

Turan B, Yazkan R (01 Haziran 2019) EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS. Medical Journal of Süleyman Demirel University 26 2 221–227.

IEEE

[1]B. Turan ve R. Yazkan, “EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS”, SDÜ Tıp Fak Derg, c. 26, sy 2, ss. 221–227, Haz. 2019, doi: 10.17343/sdutfd.492994.

ISNAD

Turan, Bilal - Yazkan, Rasih. “EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS”. Medical Journal of Süleyman Demirel University 26/2 (01 Haziran 2019): 221-227. https://doi.org/10.17343/sdutfd.492994.

JAMA

1.Turan B, Yazkan R. EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS. SDÜ Tıp Fak Derg. 2019;26:221–227.

MLA

Turan, Bilal, ve Rasih Yazkan. “EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS”. Medical Journal of Süleyman Demirel University, c. 26, sy 2, Haziran 2019, ss. 221-7, doi:10.17343/sdutfd.492994.

Vancouver

1.Bilal Turan, Rasih Yazkan. EKTOPİK PARATİROİD BEZLERİNE KLİNİK VE CERRAHİ YAKLAŞIM CLINICAL AND SURGICAL APPROACH TO ECTOPIC PARATIROID GLANDS. SDÜ Tıp Fak Derg. 01 Haziran 2019;26(2):221-7. doi:10.17343/sdutfd.492994