Careful, bloodless exploration in the cephalad direction exposed a 1.1cm, round superior parathyroid in its common location at the middle third of the gland. Further study of the CT scan revealed the enlarged gland at the level of the thyroid isthmus, consistent with the position of the clinical finding.
A small portion of the presumed inferior parathyroid was carefully biopsied using iris scissors, preserving the blood supply to the remaining gland (procedure performed using operating loupes).
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