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Parathyroid gland preservation and selective autotransplantation utilizing topical lidocaine in total thyroidectomy

Authors

  • Daniel B. Kuriloff MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.
    • 425 West 59th Street, 10th Floor, New York, NY 10019
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  • Victor Kizhner MD

    1. Department of Otolaryngology–Head and Neck Surgery, St. Luke's–Roosevelt Hospital Center, New York, New York, U.S.A.
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  • Presented at the World Congress on Thyroid Cancer, Toronto, Canada, August 8, 2009.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To review a new technique during total thyroidectomy that facilitates parathyroid gland preservation and selective autotransplantation utilizing topical 2% plain lidocaine as a spasmolytic/vasodilator agent.

Study Design:

Retrospective case series review at a university hospital.

Methods:

The study population comprised 100 consecutive patients (84 women and 16 men; mean age, 52 years) undergoing total thyroidectomy from January 2007 to December 2008. Interventions were: parathyroid glands (PGs) with signs of devascularization treated with a topical solution of 2% plain lidocaine in an attempt to restore blood flow before committing to autotransplantation.

Results:

The main outcome measure was the incidence of hypoparathyroidism. A total of 40 parathyroid glands were autotransplanted. None of the 100 patients developed permanent hypoparathyroidism. There were no adverse effects utilizing this technique.

Conclusions:

In our experience, the use of lidocaine spasmolysis is a useful technique in thyroid surgery for salvaging devascularized PGs. Its utility as a selection method for PG autotransplantation incurs minimal risk or cost and might further reduce the incidence of permanent hypoparathyroidism. Further study is warranted. Laryngoscope, 2010

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