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4 year old male Child with Neonatal severe Hyperparathyroidism

4 year old male Child with Neonatal severe Hyperparathyroidism Underwent Total Parathyroidectomy and Transcervical Thymectomy on 4/5/12 Consultants: Dr Shriram Mahadevan MD DM(Endo) Dr Dhalapathy Sadacharan MS MCh( Endocr Surg ). 5 months old child:report.

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4 year old male Child with Neonatal severe Hyperparathyroidism

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  1. 4 year old male Child with Neonatal severe Hyperparathyroidism • Underwent Total Parathyroidectomy and Transcervical Thymectomy on 4/5/12 • Consultants: • Dr ShriramMahadevan MD DM(Endo) • Dr Dhalapathy Sadacharan MS MCh(EndocrSurg)

  2. 5 months old child:report

  3. 6 months old child: serum calcium 20.1 mg%

  4. Serum Calcium 22.5 mg%

  5. Biochemistry before the day of surgery on Cinacalcet 90 mg/day

  6. Opening of Rt carotid sheath Lymph nodes found Right Common carotid artery

  7. Opening the midline strap muscles

  8. Trachea

  9. Rt lobe thyroid Left lobe Supernumerary Parathyroid over the trachea

  10. Rt lobe Thyroid CCA Rt IJV Rt Inferior Parathyroid

  11. Enlarged Rt Inf Parathyroid Thyroid Trachea Rt Rec Laryngeal Nerve

  12. Rt Inf Para Exposing the Right RLN

  13. Left Inferior Parathyroid Thymus Left RLN

  14. Left Inf Parathyroid Left Sup Parathyroid Left RLN

  15. Transcervical Thymectomy Innominate vein Carotid Trachea Thyroid

  16. Trachea Thyroid rt lobe Removal of suspected Supernumerary Parathyroid Beneath the rt RLN

  17. Trachea Left RLN in its entire course

  18. Surgical Field after Completion

  19. Post op Serum Calcium

  20. Post op PTH and Calcium with calcium supplements

  21. Child is doing well • Resumed his routine activities 6 hours after surgery • On Calcium and Vitamin D oral Supplements • Voice normal • Wound healthy

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