Vol.101 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 3 March 2008
Identification of Parathyroid Glands with
Intraoperative Use of Methylene Blue
Koji Miyata, Hideyuki Fukushima, Nobuya Fujiki, Nobumitsu Honda,
Akiko Nishida, Tsunemichi Adachi, Mika Tsujimura and Tatsuo Tsukamoto
(Kitano Hospital)
Yoshiharu Kitani
(Kyoto University)
Kiyomi Hamaguchi
(Shizuoka City Hospital)
Parathyroidectomy (PTx) is the most powerful therapeutic strategy for secondary hyperparathyroidism in patients with chronic renal failure. However, in some cases, identification of pathological parathyroid glands at PTx is not easy, resulting in sustained hyperparathyroidism. In this study, we employed methylene blue dye to discriminate abnormal parathyroid glands in 20 cases during PTx.
Methylene blue solution at a dose of 5 mg/kg was administered intravenously at the time of skin incision. In 19 of 20 cases (95％), parathyroid glands of various sizes were stained dark blue, whereas the thyroid gland was stained light blue. The dye of the canulated vein as well as pseudohypoxia indicated by pulse oxymetry was observed as a side effect of the dye in most cases as previously reported.
Intraoperative infusion of methylene blue could be a useful method of identifying parathyroid glands without any serious side effects. This might provide a beneficial tool to shorten the surgical duration and reduce the incidence of complications following PTx.
Key words :methylene blue, parathyroidectomy, secondary hyperparathyroidism