Partial Sternotomy: A Valid Approach to Mediastinal Parathyroid Adenomas

Introduction: Approximately 2% of parathyroid adenomas reside in the mediastinum and are not amenable to the traditional cervical approach. Midline full sternotomy has been frequently used to excise these glands but this approach can be associated with significant morbidity. Methods and results: Midline partial sternotomy to the third intercostal space is a valid alternative surgical approach to the exploration and removal of ectopic parathyroid glands located in the mediastinum. The surgical technique of median partial sternotomy is described. A discussion of the various approaches to upper mediastinal exploration is considered. Conclusion: Partial sternotomy is an appropriate and safe surgical technique for the exploration and removal of ectopic mediastinal parathyroid glands in the context of a previously unsuccessful parathyroid neck exploration and when localizing studies point to a mediastinal position.