Abstract
BackgroundWe aimed to minimalize operative complications by spraying of methylene blue stain on thyroid glands and the perithyroidal area.Material and methodsThe intra-operative methylene blue spraying technique was used prospectively on a total of 56 patients who had undergone primary (not recurrent) thyroid surgery for a variety of thyroid diseases. Bilateral total thyroidectomy was performed in all cases. After superior but before inferior pole ligation, 0.5ml of methylene blue was sprayed over the thyroid lobe and perilober area. Tissues, especially parathyroides, the recurrent laryngeal nerve, and the inferior thyroid artery, were identified and evaluated.ResultsRecurrent laryngeal nerve and arteries were not stained and thus they remained white in all cases while all other tissues were stained blue. Within three minutes parathyroid glands washed out the blue stain and the original yellow color was regained. Thyroid tissue wash-out time was not less than 15 minutes; perithyroideal muscles, tendinous and lipoid structures took no less than 25 minutes.ConclusionThe safety of intravascular methylene blue guidance on thyroid surgery is known. This research demonstrates the effectiveness of the spraying technique, a new technique which ensures not only identification of parathyroid glands within three minutes, but also identification of recurrent laryngeal nerves and inferior thyroid arteries.
Highlights
Disorders of the thyroid gland constitute the second most common endocrine disease following diabetes mellitus [1]
Within three minutes parathyroid glands washed out the blue stain and the original yellow color was regained
This research demonstrates the effectiveness of the spraying technique, a new technique which ensures identification of parathyroid glands within three minutes, and identification of recurrent laryngeal nerves and inferior thyroid arteries
Summary
Disorders of the thyroid gland constitute the second most common endocrine disease following diabetes mellitus [1]. Thyroidectomy is one of the most frequent operations performed in iodine-deficient regions [2,3]. The main postoperative complications of thyroidectomy are recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism [4,5,6]. Postoperative hypocalcemia after thyroidectomy leads to patient discomfort and prolonged hospital stay. The etiology appears to be multifactorial, i.e. iatrogenic hypoparathyroidism, the extent of surgery, the number of functioning glands remaining and the surgeon’s experience [7,8,9,10,11]. The overall incidence of RLN palsy is low, when it does occur nerve palsy is a devastating life-long. We aimed to minimalize operative complications by spraying of methylene blue stain on thyroid glands and the perithyroidal area
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
