Optical Tools for Intraoperative Parathyroid Identification

Abstract

Abstract

Background:

Over the past decades various techniques for fluorescence-based parathyroid identification have been introduced. It is important for parathyroid and thyroid surgeons to be familiar with these techniques. Methods: In this video, the author summarizes the pitfalls of optical tools for parathyroid identification.

Results:

The two options for optical parathyroid identification are indocyanine green (ICG) fluorescence imaging and autofluorescence imaging. The former has the ability to assess perfusion, but lacks in specificity to parathyroid glands. In contrast, the latter does not measure perfusion, but provides benefits for identification of the glands before dissection, ruling out incidental parathyroidectomies on thyroidectomy and central neck specimens, as well as in the differentiation of secreting vs suppressed parathyroid glands during parathyroid explorations. It is also possible to combine both modalities for a complementary intraoperative use.

Conclusions:

Both ICG-and autofluorescence-based optical fluorescence modalities offer benefits for parathyroid identification during thyroidectomy and parathyroidectomy procedures. A modern endocrine/head and neck surgeon should be familiar with these techniques.

No competing financial interests exist.

Running time of video: 6 mins 13 secs