Vol. 9, Issue 3, Part A (2025)

Background: Primary hyperparathyroidism (PHPT) is an endocrine condition that is characterized by the overproduction of PTH, which usually needs surgical treatment. Localization of preoperative adenomas is vital to achieve a successful outcome. Objective: This study aims to determine the effects of preoperative combined ultrasonography and sestamibi scan on surgical planning and postoperative recovery amongst patients of PHPT. Methodology: The study was a cross-sectional design carried out at Bangabandhu Sheikh Mujib Medical University between July 2022 and June 2023 and included 14 patients with biochemically verified PHPT. Preoperative high-resolution ultrasonography of the neck in all patients and technetium-99 m sestamibi scintigraphy also took place. Focused parathyroidectomy under general anesthesia was done and intraoperative assessments of PTH were carried out before and after excision. Clinical data about demographics, imaging, intraoperative correlation, postoperative complications, length of hospital stay, and cosmetic results were recorded and analyzed using SPSS v22 with the threshold of p<0.05. Result: The mean age of the patients was 32.36±9.76, and 71.4% were males. The most frequent renal symptoms were (64.3%). In 66.6% of left lower and 66.7% of the right lower adenomas, the USG correctly localized the adenomas but failed to detect 28.6% of cases, which were unnoticed and appeared as normal. Localization of lesions with sestamibi scans was 92.9% although there was a 100% concordance of supramediastinal adenomas. Imaging in combination significantly enhanced the capability to localize, reduce excessive dissection. Postoperatively, 57.1% patients experienced bone pain and circumoral paresthesia, 42.9% digital paresthesia, and 14.3% carpopedal spasm, which were all temporary and tolerable. The cosmetic result was very good in all the patients (100%). The reported average duration of hospital stay was 8.2±6.26 days. Conclusion: The combination of ultrasonography and sestamibi scan added to the surgical accuracy and patient recovery in PHPT, justifying frequent usage as part of preoperative planning.