Intraoperative identification of parathyroid glands: appraisal of methylene blue staining

Methylene blue administered intravenously in a dose of 5 mg/kg of body weight was employed as an aid to the intraoperative identification of parathyroid glands in 90 patients undergoing surgery for hyperparathyroidism. Staining occurred in 95 percent of adenomas and 86 percent of hyperplastic glands. Normal and suppressed glands stained in 71 and 70 percent of cases, respectively. There were no adverse side effects from the technique. We conclude that preoperative intravenous infusion of methylene blue is a valuable technique that facilitates identification of parathyroid tissue at operation.