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

✍ Scribed by Daniel B. Kuriloff; Victor Kizhner


Book ID
102452151
Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
152 KB
Volume
120
Category
Article
ISSN
0023-852X

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✦ Synopsis


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