Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy
Orban, Y., Ismail, A., Baz, Y., Abdelazez, O., Alkilany, M. (2022). Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy. EKB Journal Management System, 88(1), 3741-3745. doi: 10.21608/ejhm.2022.251660
Yasser A. Orban; Adel M. Ismail; Yasser Baz; Osama Abdelazez; Mohamed M. Alkilany. "Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy". EKB Journal Management System, 88, 1, 2022, 3741-3745. doi: 10.21608/ejhm.2022.251660
Orban, Y., Ismail, A., Baz, Y., Abdelazez, O., Alkilany, M. (2022). 'Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy', EKB Journal Management System, 88(1), pp. 3741-3745. doi: 10.21608/ejhm.2022.251660
Orban, Y., Ismail, A., Baz, Y., Abdelazez, O., Alkilany, M. Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy. EKB Journal Management System, 2022; 88(1): 3741-3745. doi: 10.21608/ejhm.2022.251660

Methylene Blue Spray versus Conventional Surgical Techniques for Identification of Recurrent Laryngeal Nerve and Parathyroid Glands during Thyroidectomy

The Egyptian Journal of Hospital Medicine
Article 235, Volume 88, Issue 1, July 2022, Page 3741-3745  XML PDF (581.55 K)
DOI: 10.21608/ejhm.2022.251660
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Authors
Yasser A. Orban email 1; Adel M. Ismail2; Yasser Baz3; Osama Abdelazez1; Mohamed M. Alkilany1
11Department of Surgery, Faculty of Medicine, Zagazig University, Egypt
22Department of Surgical Oncology, Ismailia Teaching Oncology Hospital, Ismailia, Egypt
33Department of Surgery, Faculty of Medicine, Helwan University, Egypt
Abstract
Background: Thyroid surgeries are commonly operated head and neck surgeries. Significant morbidity is caused by thyroidectomy complications such as recurrent laryngeal nerve (RLN) and parathyroids injuries.
Objective: To reduce the risk of complications after thyroidectomy, we employed methylene blue spray to locate the RLNs and parathyroid glands.
Patients and method: This was a prospective, randomized, controlled trial of 80 patients with thyroid disease who were eligible for total thyroidectomy. Group 1: patients were managed by traditional thyroidectomy where the RNL and parathyroid glands were identified anatomically. Group 2: Diluted methylene blue spray was used to aid in the identification of the RLN and the parathyroid glands.
Results: Both groups had the RLN identified. In group 2 the neve did not take the dye and remained white. At least one of the parathyroid glands could be identified in 35 patients in group 1, while it was identified in 37 patients in group 2. The parathyroid was stained with methylene blue then the dye was washed out in 3 minutes. Neither group had a statistically significant advantage over the other in identifying the parathyroid gland, p-value=0.356. The RLN was identified in all patients of both groups.
Conclusion: Methylene blue dye spraying is technically feasible, safe, and effective method for identifying and protecting the RLN and parathyroid glands during thyroidectomy. It can be used as adjunct for the identification of these structures in difficult cases. Minimizing postoperative hypocalcemia requires accurate identification of at least one of the parathyroid glands.
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