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Related Concept Videos

The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Related Experiment Video

Updated: Sep 2, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Usefulness of ICG Angiography-Guided Thyroidectomy for Preserving Parathyroid Function.

Pablo Moreno-Llorente1, Arantxa García-Barrasa2, Mireia Pascua-Solé2

  • 1Endocrine Surgery Unit, Department of Surgery, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. 25108pml@gmail.com.

World Journal of Surgery
|August 9, 2022
PubMed
Summary

Indocyanine green (ICG) angiography significantly reduces hypocalcemia after total thyroidectomy by improving parathyroid gland preservation. This technique aids in identifying parathyroid gland vascularization, leading to better patient outcomes.

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Area of Science:

  • Endocrine Surgery
  • Surgical Oncology
  • Vascular Imaging

Background:

  • Hypoparathyroidism is a frequent complication following total thyroidectomy, potentially leading to severe chronic illness.
  • Preserving parathyroid gland (PG) function is crucial to prevent postoperative hypocalcemia.

Purpose of the Study:

  • To assess the efficacy of indocyanine green (ICG) angiography-guided thyroidectomy in reducing postoperative hypocalcemia.
  • To evaluate the impact of ICG angiography on parathyroid gland vascularization and preservation.

Main Methods:

  • A prospective study comparing a historical control group (CG) with an angiography-guided thyroidectomy group (AG).
  • ICG angiography was used post-surgery to predict immediate PG function and, in the AG, to visualize PG vascular supply.
  • Postoperative and permanent hypocalcemia rates were compared between the two groups.

Main Results:

  • The angiography-guided group (AG) showed significantly lower rates of postoperative hypocalcemia (5.6% vs. 26.2%) and permanent hypocalcemia (0% vs. 11.9%).
  • A higher rate of well-vascularized PGs (score 2) was observed in the AG (52.9% vs. 39.2%).
  • The odds ratio for permanent hypocalcemia was significantly reduced in the AG.

Conclusions:

  • ICG angiography-guided thyroidectomy is an effective tool for identifying PG vascularization.
  • This technique enables better PG preservation, leading to a significant reduction in hypocalcemia rates after total thyroidectomy.