Intraoperative identification of parathyroids by means of methylene blue

In 134 cervical explorations for hyperparathyroidism, methylene blue was administered intraoperatively to stain parathyroid glands. Seventy-seven out of 79 adenomas (97.5%) and 199 out of 204 hyperplastic glands (97.6%) were clearly stained. The only recurrences were observed in patients undergoing surgery for hyperplasia of the parathyroid glands. The recurrences (12%) were mainly due either to initial wrong diagnosis of parathyroid adenoma, or they were graft dependent. Methylene blue is an effective, safe and easy way to localize and identify abnormal parathyroid glands, thereby improving the results and shortening the operating time.