Parathyroid biopsy to facilitate the preservation of functional parathyroid tissue during thyroidectomy
Background The preservation of viable parathyroid tissue, either by preserving parathyroid glands in situ with an intact blood supply or by autotransplantation, is an integral element of thyroid surgery. There is a general impression that nonviable parathyroid glands can be recognized on the basis o...
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Published in | Head & neck Vol. 21; no. 5; pp. 442 - 446 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
New York
John Wiley & Sons, Inc
01.08.1999
John Wiley & Sons |
Subjects | |
Online Access | Get full text |
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Summary: | Background
The preservation of viable parathyroid tissue, either by preserving parathyroid glands in situ with an intact blood supply or by autotransplantation, is an integral element of thyroid surgery. There is a general impression that nonviable parathyroid glands can be recognized on the basis of black or purple‐black discoloration of the gland. We came to believe that this is not a reliable way to assess the viability of parathyroid glands because we observed that when we excised parathyroid glands (with the intention of reimplanting them) in situations where it was not feasible to preserve their blood supply, they did not become discolored.
Methods
To assess the status of the parathyroid blood supply, we performed incisional biopsies of suspected parathyroid glands during 14 consecutive thyroid operations (9 hemithyroidectomies, 1 completion thyroidectomy, 4 total thyroidectomies), and observed the biopsy site for evidence of active bleeding.
Results
Thirty‐four of 36 possible parathyroid glands were histologically confirmed. Seventeen bled actively from the biopsy site and were preserved in situ. The other 17 were felt to be nonviable: 5 were severely discolored (black) and either no bleeding or minor venous oozing was seen when they were biopsied; 12 with normal coloration (3 were harvested prior to biopsy), did not bleed actively following an incisional biopsy. Parathyroid glands that were judged to be devascularized were autotransplanted into the sternocleidomastoid muscle.
Conclusions
The absence of discoloration is not a reliable way to determine whether the parathyroid blood supply is intact. Biopsy of the parathyroid glands during thyroid surgery facilitates the identification of devascularized parathyroid glands that can be salvaged with autotransplantation. © 1999 John Wiley & Sons, Inc. Head Neck 21: 442–446, 1999. |
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Bibliography: | ArticleID:HED10 ark:/67375/WNG-3TMWWQVB-T istex:EFF88DFE1002C14D5A19EAFE5337FC6C9BF770A1 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1043-3074 1097-0347 |
DOI: | 10.1002/(SICI)1097-0347(199908)21:5<442::AID-HED10>3.0.CO;2-Z |