The Role of Methylene Blue in Identification of Parathyroid Glands during Total Thyroidectomy | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 355-361 PDF (471.78 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.412888.1228 | ||
| Authors | ||
| Mohamed Ibrahim Abd El Aziz Elzanaty* ; Ahmed Elgendy; Waleed El Sherpiny; Ayman Elnemr; Hossam Ramadan | ||
| Surgical Oncology Unit, General Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt | ||
| Abstract | ||
| Introduction: Methylene blue (MB) spray was used to identify the parathyroid gland’s location. The parathyroids are capable of absorption of the blue staining and regaining their original yellow color in three minutes, however, other tissues take more time. Aim of work: To evaluate safety and efficacy of MB spray in identifying parathyroid glands during total thyroidectomy. Patients and methods: This randomized prospective study included 30 patients aged ≥18 years with various thyroid diseases undergoing total thyroidectomy using MB spray for parathyroid gland detection. Findings were compared with 30 patients who underwent total thyroidectomy using conventional methods without MB spray. Results: No substantial variations existed regarding identification of parathyroids and recurrent laryngeal nerves. There was only one case that developed transient hypo-calcemic symptoms in group I and another case in group II that improved with medical treatment. There were no any recorded cases that suffered from post-operative recurrent laryngeal nerve injury symptoms, wound infection, seroma or haematoma collection. The mean value of postoperative ionized calcium levels was 4.32 ± 0.76 mg/dl and of total calcium levels was 8.47±1.55 mg/dl. The mean value of postoperative parathyroid hormone levels was 19.51 ± 5.64 pg/ml. Conclusion: MB spraying is technically viable and secure but has no significant role in preservation of the parathyroid glands throughout thyroidectomy, with no value in minimizing the incidence of postoperative hypocalcemia. Meticulous dissection is the fundamental component for conservation of the parathyroid glands throughout thyroidectomy. | ||
| Keywords | ||
| Methylene blue spray; parathyroid glands; identification; total thyroidectomy | ||
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