Calcium Conundrums

PROGRAM DESCRIPTION: Hypercalcemia is a common problem encountered by otolaryngologists in the academic and private practice setting. Hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, but there are other less common causes that should be considered in the differential diagnosis particularly because of the importance in avoiding parathyroid surgery in patients with hypercalcemia due to other causes. Additionally, elevated PTH levels are often indicative of primary hyperparathyroidism but may also be due to other causes which should not be addressed surgically.
The purpose of this session is to provide a comprehensive discussion of the diagnosis and management of hypercalcemia and hyperparathyroidism including low biochemical profile versions. Calcium metabolism will be reviewed and the appropriate evaluation of a patient with hypercalcemia will be discussed. Multiple case presentations (hyperparathyroidism as well as uncommon causes of hypercalcemia and/or PTH elevation) will be used to illustrate the pearls and pitfalls of hypercalcemia evaluation/treatment and parathyroid surgery.
This program was well received at the 2023 meeting. The primary change in the presentation if accepted for 2024 will be to remove the discussion of hypocalcemia avoidance and management. Given the time length of the session, it was not possible to cover the topics of hyper- and hypo-calcemia in as much detail as would be warranted. Instead, additional cases highlighting challenges in surgery for hyperparathyroidism (including reoperative surgery and non-localized primary hyperparathyroidism) will be discussed which will allow the discussion to focus on hypercalcemia and hyperparathyroidism rather than parathyroid management during thyroid surgery.