Some patients will need more extensive parathyroid surgery to achieve cure. The surgeons at the Endocrine Surgery Parathyroid Program have considerable experience in treating even the most complicated parathyroid conditions. We obtain state of the art parathyroid imaging prior to surgery which can often determine if more than one parathyroid gland is abnormally enlarged. One such advance is parathyroid CT scanning. Our program’s dedicated parathyroid radiologist performs and interprets all parathyroid CT scans performed at Mount Sinai. At surgery, our program’s parathyroid surgeons use a combination of the preoperative imaging results, surgical findings, surgeon experience and intraoperative parathyroid hormone testing to determine the extent of parathyroid exploration. If necessary, all of the parathyroid glands will be identified and appropriately treated, usually under local anesthesia. Our underlying principle is to perform the least amount of surgery possible to cure the patient of their parathyroid hyperactivity.