Parathyroid
autotransplantation is a known and increasingly utilized procedure. It is indicated in patients with primary parathyroid
hyperplasia, in patients with primary
hypercalcemia who have normal parathyroid tissue devascularized during surgery, in patients with secondary and tertiary parathyroid
hyperplasia, and in patients with total
thyroidectomy when normal parathyroid tissue is accidentally or unavoidably removed or completely devascularized. No normal viable parathyroid tissue should be autotransplanted. This procedure was performed in 13 dialysis patients, 27 primary hypercalcemic patients and 77 patients with
thyroidectomy. The hypercalcemic patients had
autotransplantations into muscle pockets in the volar surface of the forearm, while the
thyroidectomy patients had
autotransplantation into the sternocleidomastoid muscles. The application of parathyroid
autotransplantation is a major technical and physiologic breakthrough in the field of thyroid and parathyroid surgery. It should greatly reduce the morbidity associated with permanent
hypocalcemia in this type of extensive surgery.