# Accuracy of ultrasound performed by medical residents in operating rooms in identifying parathyroid glands in patients with hyperparathyroidism

## TL;DR

Medical residents can accurately identify parathyroid glands using ultrasound in patients with hyperparathyroidism and kidney disease.

## Contribution

Medical residents achieved 81.25% accuracy in identifying parathyroid glands via intraoperative ultrasound in hyperparathyroidism patients with CKD.

## Key findings

- At least one parathyroid gland was identified in 81% of patients.
- Ultrasound exams by residents showed 81.25% accuracy compared to intraoperative findings.
- Sensitivity was 76% for glands larger than 5 mm in hyperparathyroidism with CKD.

## Abstract

•Ultrasonography is a useful tool for diagnosing head and neck diseases, and recently HN surgeons have incorporated it into their practice.•US examinations before surgery and during the procedure, just before the parathyroidectomy, were done by the HNS residents.•These exams accurately identified parathyroids in 81.25% of the patients with hyperparathyroidism with CKD.•Although this is a small casuistic (11 patients), the method is promising.

Ultrasonography is a useful tool for diagnosing head and neck diseases, and recently HN surgeons have incorporated it into their practice.

US examinations before surgery and during the procedure, just before the parathyroidectomy, were done by the HNS residents.

These exams accurately identified parathyroids in 81.25% of the patients with hyperparathyroidism with CKD.

Although this is a small casuistic (11 patients), the method is promising.

To describe the findings of US examinations performed by Head and Neck Surgery (HNS) resident physicians in patients in the preoperative period immediately before parathyroidectomy, and to compare these results with those of examinations performed preoperatively (ultrasonography and/ or scintigraphy) and with the findings of surgical procedures.

Patients in the preoperative period of parathyroidectomy underwent US examinations performed by HNS resident physicians after induction of anesthesia. The findings were registered and later compared with those of preoperative and intraoperative examinations using descriptive statistical analysis and calculation of sensitivity, specificity, and accuracy.

At least one gland was identified in 81% of the patients, most commonly the left inferior parathyroid. There was 63% agreement between the examinations performed in the operating room and the preoperative examinations. Sensitivity of 76%, specificity of 100%, and accuracy of 81.25% were evidenced in identifying parathyroids > 5 mm in patients with hyperparathyroidism associated with Chronic Kidney Disease (CKD), and sensitivity of 33% was found in patients with primary hyperparathyroidism.

US examinations performed by HNS resident physicians in patients preoperatively to parathyroidectomy are accurate (81.25%) in identifying parathyroids compared with intraoperative findings in patients with hyperparathyroidism associated with CKD.

Level III.