Avoiding Complications of Thyroidectomy: Preservation of Parathyroid Glands

Otolaryngol Clin North Am. 2024 Feb;57(1):63-74. doi: 10.1016/j.otc.2023.07.009. Epub 2023 Aug 31.

Abstract

Preservation of functional parathyroid glands during thyroidectomy and central neck surgery is crucial to avoid the common but serious complication of hypoparathyroidism. The first requirement is a solid foundational knowledge of anatomy and embryology which then enables the surgeon to use meticulous anticipatory dissection with identification and preservation of blood supply to the parathyroids. When preservation of blood supply is not possible, autotransplantation should be performed. New technologies harnessing the natural phenomenon of parathyroid autofluorescence to detect parathyroid tissue and indocyanine green to perform angiography may lead to improved outcomes with low risk to patients.

Keywords: Autofluorescence; Hypoparathyroidism; Parathyroid preservation.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypoparathyroidism* / etiology
  • Hypoparathyroidism* / prevention & control
  • Hypoparathyroidism* / surgery
  • Parathyroid Glands* / diagnostic imaging
  • Parathyroid Glands* / surgery
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery
  • Thyroidectomy / adverse effects
  • Transplantation, Autologous / adverse effects