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Updated: Jun 11, 2026
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Parathyroid gland preservation and selective autotransplantation utilizing topical lidocaine in total thyroidectomy
Daniel B Kuriloff1, Victor Kizhner
1Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA. kuriloff@nyhni.org
Objectives/Hypothesis:
To review a new technique during total thyroidectomy that facilitates parathyroid gland preservation and selective autotransplantation utilizing topical 2% plain lidocaine as a spasmolytic/vasodilator agent.
Study Design:
Retrospective case series review at a university hospital.
Methods:
The study population comprised 100 consecutive patients (84 women and 16 men; mean age, 52 years) undergoing total thyroidectomy from January 2007 to December 2008. Interventions were: parathyroid glands (PGs) with signs of devascularization treated with a topical solution of 2% plain lidocaine in an attempt to restore blood flow before committing to autotransplantation.
Results:
The main outcome measure was the incidence of hypoparathyroidism. A total of 40 parathyroid glands were autotransplanted. None of the 100 patients developed permanent hypoparathyroidism. There were no adverse effects utilizing this technique.
Conclusions:
In our experience, the use of lidocaine spasmolysis is a useful technique in thyroid surgery for salvaging devascularized PGs. Its utility as a selection method for PG autotransplantation incurs minimal risk or cost and might further reduce the incidence of permanent hypoparathyroidism. Further study is warranted.
