الفهرس 
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Abstract
HPT is generally divided into three types: primary (autonomous HPT), secondary (HPT that results from a chronic stimulus causing PTH secretion) and tertiary (emergence of autonomous HPT in refractory secondary HPT).
Clinicopathological correlates of HPT include parathyroid adenoma (Most common in 1ry HPT), hyperplasia (Most common in 2ry HPT) or carcinoma.
The most common laboratory investigation is PTH, Serum Ca, Serum Phosphorus. The most common radiological investigation in SHPT cases is US, while CT scan and sistamibi scan is done in some cases especially in recurrent cases.
Evaluation of vocal cord function should be considered in patients referred for surgery. It is mandatory in patients who have had previous cervical or mediastinal surgery and in patients with symptoms or signs of vocal cord dysfunction. It is easily performed by indirect mirror examination or flexible fiber optic laryngoscopy.
However, treatments according to these guidelines do not always provide control of the parathyroid disorder. Some patients require surgical treatment: parathyroidectomy, Successful surgical treatment often results in a dramatic DROP in the parathyroid hormone (PTH) levels, relieves the patient from clinical symptoms, and reduces mortality.
Surgical management of HPT remains the only treatment option, bilat. neck exploration is the most common operation which provide assessment of all parathyroid glands. Parathyroidectomy seems to have a good influence on patients with chronic kidney disease with SHPT, especially those who complain from bone pain, and decreased daily activity.