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Hidden Gems: in Pursuit of Parathyroid Gland Identification During Neck Surgeries

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Abstract

The preservation of parathyroid glands is now understood to be quintessential during neck surgeries mainly thyroid surgeries. Because of its small size, colour, shape and variability in position and number, they are very prone to inadvertent resection of one of the glands or devascularization leading to either transient or permanent hypocalcaemia during thyroid surgery. Permanent hypocalcemia being a serious complication causing life-long morbidity. This understanding necessitated the need to invent a reliable and simple modality for identification and consequent preservation. With this systematic review, we aim to describe a comprehensive timeline of how the parathyroid gland was discovered, its physiology and relevance in life established along with that we aim to outline and concise most of the methods used in intra-operative parathyroid gland identification which have been developed and experimented upon. Numerous modalities have been used such as frozen section, intra-operative parathyroid hormone levels, methylene blue injection, local methylene blue spray, indocyanine green angiography, carbon nanoparticle injection, Raman spectroscopy, shear wave elastography, laser speckle contrast imaging, dynamic optical contrast imaging and near infrared-induced autofluorescence. To conclude, we have come a long way in discovering the gland and knowing its importance and its surgical preservation, but we still have a long way to go in finding a more cost-efficient and universal method to identify glands intra-operatively.

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  1. Department of ENT, Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Sitapura, Jaipur, Rajasthan, 302022, India

    Priyanshi Gupta & Pratibha Vyas

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Gupta, P., Vyas, P. Hidden Gems: in Pursuit of Parathyroid Gland Identification During Neck Surgeries. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03845-6

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