Imaging and surgery in hyperparathyroidism: a 10-year review.

A 10-year review (1984-1994) of patients undergoing surgical treatment for hyperparathyroidism at St. Joseph's Health Centre in London, Ontario, is presented. The role of preoperative localization is discussed. We review our experience with the various imaging modalities and their usefulness in the surgical decision-making process. Our experiences with the surgical management of both primary and secondary hyperparathyroidism are evaluated. Controversies in parathyroid surgery, unilateral versus bilateral neck exploration for parathyroid adenomas, and autotransplantation versus total parathyroidectomy for secondary hyperparathyroidism are discussed and our approach is explained.