Introduction: Primary Hyperparathyroidism (PHPT) is caused by single adenoma in most of the cases and surgery is the only curative management till now. Routine frozen section was and still an important operative step for many surgeons but with the introduction of highly accurate preoperative localization with sestamibi scan and available IOPTH assay, can surgeons skip this step? Objectives: Comparing IOPTH alone versus combined IOPTH and frozen section for detecting successful parathyroidectomy in cases of primary hyperparathyroidism. Patients and methods: Forty patients with primary hyperparathyroidism and indicated for parathyroidectomy were divided into 2 groups, Group A had only IOPTH assay while group B had both IOPTH and frozen section for parathyroid tissue confirmation. Results and conclusion: The 2 groups had similar features regarding demographics. The mean time for receiving FS results was statistically highly significant when compared with IOPTH mean time (P value less than 0.0001). Those results were consistent with those resulting from calculating the total operative time in both groups which were undoubtfully and statistically in favor of IOPTH alone group. IOPTH assay when available could alone guide intraoperative decision-making during parathyroidectomy surgeries. Disclosure: This article is not sponsored by any company, so the authors have no competing interests as defined by Nature Publishing Group, or other interests that might be perceived to influence the results and/or discussion in this article.

Keywords: Primary Hyperparathyroidism, intraoperative parathyroid hormone assay, parathyroidectomy, frozen section.