Parathyroid glands: Homeostasis, disease and indications for surgical treatment

The parathyroid glands were first described by Sir Richard Owen in1849 following the anatomical dissection of an Indian rhinoceros that haddied in the London Zoo. Their existence was confirmed in humans byRemark in 1855 and by Virchow in 1863. The superior parathyroidglands are derived from the fourth branchial pouch, which also gives riseto the thyroid gland. The third branchial pouches give rise to the inferiorparathyroid glands and the thymus. The parathyroids remain closelyassociated with their respective branchial pouch derivatives duringdevelopment, an anatomical fact that has a significant impact onparathyroid surgery.The first to correlate parathyroid function with bone disease wasSchlagenhaufer, a Viennese physician who in 1915 reasoned that patientswith osteitis fibrosa cystica had an enlarged parathyroid gland, suggestinga nexus between the two events. He also suggested that the bone diseasewas the result rather than the cause of parathyroid hyperplasia and thatparathyroidectomy may alleviate the bone disease.