OBJECTIVE: Calciphylaxis, a rare disorder typically affecting renal failure 
patients, results in vascular calcification with subsequent skin necrosis, 
gangrene, and often death from sepsis. Parathyroid hormone is thought to act as 
a tissue sensitizer leading to these soft tissue changes. As such, 
parathyroidectomy is often advocated to control this complicated condition. A 
discussion of calciphylaxis does not exist in the otolaryngology literature, and 
head and neck surgeons performing parathyroidectomy should be aware of this 
phenomenon. This study evaluates the success of parathyroidectomy in reversing 
the ill effects of calciphylaxis in both our patient population and the 
literature.
STUDY DESIGN: Retrospective study and review of the literature.
METHODS: Five patients with calciphylaxis treated at our institution were 
evaluated for mortality, surgical and perioperative complications, wound 
healing, and predictors of patient outcomes.
RESULTS: Two patients died from sepsis and infectious complications of their 
calciphylaxis shortly after surgery. Of the three survivors, two later died (15 
and 18 mo after surgery) from causes not directly related to calciphylaxis. The 
other long-term survivor required partial amputation of a leg for osteomyelitis. 
There was one operative complication-- wound infection requiring antibiotic 
therapy, drainage, and packing. Postoperative hypocalcemia required treatment in 
two patients. Immediate perioperative survival was more likely in patients with 
leukocyte counts less than 20,000 cells/mL.
CONCLUSIONS: Calciphylaxis is a serious disease and patients often succumb to 
sepsis and infectious complications. Patients with extremely high leukocyte 
counts from coexistent infections may have a worse prognosis. Although a 
conclusive effective therapy does not exist, parathyroidectomy can be safely 
performed and may benefit some patients with what is often an otherwise fatal 
disease. The literature to date generally confirms our findings. Key Words: 
Calciphylaxis, parathyroid hormone, parathyroidectomy, skin necrosis, chronic 
renal failure.