Parathyroid surgery and methylene blue: A review with guidelines for safe intraoperative use

✍ Scribed by Geoffrey Pollack; Aron Pollack; Joel Delfiner; John Fernandez

• Book ID: 102449065
• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 77 KB
• Volume: 119
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.20581

✦ Synopsis

Abstract

Methylene blue has been used to help facilitate parathyroid surgery for over 30 years. Its use has been widely considered both safe and cost effective. Twenty‐six cases of a toxic metabolic encephalopathy, however, have been reported with its use. As a result, some surgeons have stopped using this technique altogether. It is now known that methylene blue is a monoamine oxidase inhibitor. When combined with drugs that increase central serotonin neurotransmission, serotonin toxicity results. This is the cause of the encephalopathy described in the literature. A case report, review of the literature, and guidelines as to its proper use are presented so as to allow for safe parathyroid surgery. Laryngoscope, 2009