Publication: Safe thyroidectomy with intraoperative methylene blue spraying.
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Date
2012-11-13
Authors
SARI, S
Aysan, E
MUSLUMANOGLU, M
ERSOY, YELİZ EMİNE
BEKTASOGLU, HÜSEYİN KAZIM
YARDıMCı, ERKAN
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Abstract
Background: We aimed to minimalize operative complications by spraying of methylene blue stain on thyroid
glands and the perithyroidal area.
Material and methods: The 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.
Results: Recurrent 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.
Conclusion: The 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.
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Citation
SARI S., Aysan E., MUSLUMANOGLU M., ERSOY Y. E. , BEKTASOGLU H. K. , YARDıMCı E., -Safe thyroidectomy with intraoperative methylene blue spraying.-, Thyroid research, cilt.5, ss.15, 2012