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Updated: Jul 11, 2026

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Methylene Blue Spray as a Tool for Safe Thyroidectomy.

Narendra Ballal1, Manjunath S Kotennavar1, Aravind V Patil1

  • 1General Surgery, BLDE (Deemed to be University) Shri BM Patil Medical College Hospital and Research Centre, Vijayapura, IND.

Cureus
|December 17, 2024
PubMed
Summary

Methylene Blue dye aids surgeons in identifying parathyroid glands and the recurrent laryngeal nerve (RLN) during thyroidectomies, improving safety and reducing complications. This method offers high accuracy and is a reliable, cost-effective tool for thyroid surgery.

Keywords:
identificationmethylene blue sprayparathyroidrecurrent laryngeal nervethyroid

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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.