الفهرس 
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Abstract
Objective : The aim of this work was to study the effect of parathyroidectomy on patients with tertiary hyperparathyroidism. Patients and methods : A total number of 10 patients with tertiary hyperparathyroidism manifestations under went parathyroidctomy, where the patients with adenoma of parathyroid gland under went excision of adenoma or multiple adenomas, and patients with hyperplasia of parathyroid gland underwent total parathyroidectomy and implantation of a part of one parathyroid gland into the sternomastoid muscle . Results: There were significant changes in clinical and laboratory values between pre- and post operative measures in both types of patients (adenoma and hyperplasia) where there were significant decrease in serum calcium , serum alkaline phosphatase and parathyroid hormone (P.T.H.) and great changes in preoperative manifestations. Conclusion: from this study we can conclude that the optimal treatment of tertiary hyperparathyroidism is surgical excision of adenoma or adenomas , or total parathyroidectomy and transplantation of a part of one gland into the sternomastoid muscle in case of hyperplasia of parathyroid gland