Related Experiment Video
Updated: Aug 24, 2026
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Factors influencing identification accuracy rate of parathyroid glands using near-infrared autofluorescence during
Lihua Ao1, Yilin Li1, Jiaqi Cen1
1Nanshan School, Guangzhou Medical University, Guangzhou, Guangdong, China.
Background:
Near-infrared autofluorescence (NIRAF) enhances parathyroid gland (PG) identification during thyroidectomy. However, its identification rate is frequently affected by false-positive and false-negative results.
Methods:
This prospective cohort study enrolled 50 patients scheduled for endoscopic thyroidectomy, employing a 1:1 case-matched design. The patients were assigned to an experimental group (NIRAF group; n = 25) and a control group (Non-NIRAF group; n = 25).
Results:
In the NIRAF group, levels of parathyroid hormone (PTH) on the first postoperative day (P = 0.002) and at the first postoperative month (P = 0.04), as well as serum calcium levels at the first month, were significantly higher than those in the Non-NIRAF group (P = 0.03). The sensitivity and specificity of NIRAF for identifying PGs were 80% and 84%, respectively. A higher body mass index (BMI) was associated with an increased incidence of false negatives (P = 0.07). Four false-positive events were recorded, originating from a thyroid nodule, thymus, adipose tissue, and a lymph node.
Conclusion:
NIRAF is a highly sensitive navigation tool that effectively improves PG preservation and postoperative outcomes. Nevertheless, its diagnostic accuracy is challenged by false positives from heterogeneous tissues and false negatives driven by anatomical barriers like excessive fat.
