Methylene Blue Spray as a Tool for Safe Thyroidectomy.

Area of Science:

• Surgical Anatomy
• Endocrine Surgery
• Surgical Navigation

Background:

• Thyroid surgery presents challenges due to complex anatomy, risking injury to parathyroid glands and the recurrent laryngeal nerve (RLN).
• Effective intraoperative identification of these structures is crucial for minimizing surgical complications during thyroidectomy.

Purpose of the Study:

• To evaluate the efficacy and diagnostic value of Methylene Blue dye in identifying and preserving parathyroid glands and the RLN during thyroidectomies.
• To assess the dye's role in minimizing injury and improving outcomes in thyroid surgery.

Main Methods:

• An interventional study involving 66 patients undergoing thyroidectomies.
• Methylene Blue dye was used intraoperatively, with identification based on tissue color return time.
• Preoperative and postoperative serum calcium and parathyroid hormone (PTH) levels, complications, and outcomes were monitored.

Main Results:

• Methylene Blue demonstrated high diagnostic accuracy: 98.46% sensitivity, 97.01% specificity, and 97.73% overall accuracy for structure detection.
• No significant drop in postoperative serum calcium or PTH levels was observed; complications were minimal and fully resolved.
• The dye showed no allergic reactions and facilitated easier dissections, with no impact on hospital stay duration.

Conclusions:

• Methylene Blue dye is a reliable, affordable, and accessible method for intraoperative identification and preservation of parathyroid glands and RLN.
• Its use enhances thyroidectomy safety, reduces the risk of complications, and simplifies surgical procedures.