Consideration of Submandibular (Undescended) Ectopic Parathyroid Glands in Surgery and Localization Studies.

Consideration of Submandibular (Undescended) Ectopic Parathyroid Glands in Surgery and Localization Studies Anatomyof theparathyroidglandsvaries.Duringembryogenesis, precursor glands descend from the third and fourth pharyngeal pouches into the neck, but up to 20% end up in “ectopic” locations.1 Adenomas that develop fromundescended glands in the submandibular region aredifficult to identify on standard imaging andaccount for 7%of cases of persistenthyperparathyroidism following parathyroidectomy.2 Undescendedadenomasarewell described inendocrine surgery literaturebutnearly absent fromotolaryngology literature.With approval fromEastern VirginiaMedical School’s institutional reviewboard to use patient cases in a deidentified format,we identified the senior authors’ (J.T.W. andD.W.K.) patientswith undescended parathyroid adenomas.