Anatomy and embryology of the parathyroid gland

Experienced parathyroid surgeons recognize that the embryology of the parathyroid glands would guide them in their anatomic dissections to localize the abnormal glands. This becomes particularly important in circumstances when the glands are not in their “normal” locations. Surgeons must be familiar with the embryology that is so inherently linked with the final anatomic location of the glands. It is not uncommon for patients to have undergone failed surgical explorations secondary to parathyroid glands being in ectopic locations that were not appreciated. Parathyroid embryology knowledge can bridge that gap and direct the surgeon to those sites. In this article, variations in anatomic location, relation to critical structures including the recurrent laryngeal nerve, the number of glands, and even gland size and morphology would be explored and thereby provide the platform for parathyroid surgery.