Abstract
The blood supply of 53 normal human parathyroid glands was studied with laser Doppler flowmetry in 45 patients undergoing operations on the thyroid and parathyroid glands. The inferior and superior thyroid arteries and other vessels that might supply the parathyroid glands were occluded so their contribution to parathyroid perfusion could be studied. Occlusion of the main trunk of the inferior thyroid artery resulted in a reduction of blood flow by one-third, and a similar reduction was obtained after occlusion of the superior thyroid artery. The results demonstrate that the blood supply to the parathyroid glands is not as dependent on the inferior thyroid artery as has previously been suggested but that other routes of blood supply may be equally or, in some cases, even more important.
Résumé
La vascularisation de 53 glandes parathyroïdes provenant de 45 patients opérés d'une affection thyroïdienne ou parathyroïdienne a été étudiée par l'examen Döppler. Les artères thyroïdiennes inférieure et supérieure et d'autres vaisseaux qui auraient pu vasculariser les glandes parathyroïdes ont été clampés de façon à étudier leur contribution à la perfusion de la glande. Le débit sanguin a été réduit d'un tiers lors de l'occlusion de l'artère thyroïdienne inférieure ou supérieure. Ces résultats démontrent que la vascularisation des glandes parathyroïdes ne dépend pas uniquement de l'artère thyroïdienne inférieure comme il est classique de dire, mais que d'autres vaisseaux peuvent y contribuer avec un débit similaire voire supérieur à celui de cettc artère.
Resumen
Se realizó el estudio de la irrigación arterial de 53 glándulas paratiroides normales mediante flujometría con Doppler en 45 pacientes sometidos a operaciones sobre la tiroides o las paratiroides. Se efectuó la oclusión de las arterias tiroideas inferior y superior, y de otros vasos que pudieran irrigar las glándulas paratiroides, con el propósito de estudiar su contribución a la perfusión paratiroidea. La oclusión del tronco principal de la arteria tiroidea inferior resultó en una reducción del flujo sanguineo correspondiente a un tercio, y una reducción similar se obtuvo luego de la oclusión de la arteria tiroidea superior.
Los resultados del estudio demuestran que la irrigación sanguínea de las glándulas paratiroides no está dependiente de la arteria tiroidea inferior como se ha sugerido en el pasado, y que otras rutas de irrigación pueden ser igualmente, o en algunos casos más, importantes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
McKenzie, A.D.: The natural history of thyroid cancer. Arch. Surg. 102:274, 1971
Harrold, C.C., Wright, J.: Management of surgical hypoparathyroidism. Am. J. Surg. 112:482, 1966
Hardin, W.J., Hardy, J.D.: Carcinoma of the thyroid gland. Surg. Gynecol. Obstet. 132:450, 1971
Lennquist, S.: Surgical strategy in thyroid carcinoma: a clinical review. Acta Chir. Scand. 152:321, 1986
Thompson, N., Vinik, A.: Endocrine Surgery Update, Orlando, FL, Grune & Stratton, 1983, pp. 71–84
Clark, O.H.: Total thyroidectomy—the treatment of choice for patients with differentiated thyroid cancer. Ann. Surg. 196:361, 1982
Attie, J.N., Khafif, R.A.: Preservation of parathyroid glands during total thyroidectomy. Am. J. Surg. 130:399, 1975
Falk, S.A., Birken, E.A., Baran, D.T.: Temporary post-thyroidectomy hypocalcemia. Arch. Otolaryngol. Head Neck Surg. 114:168, 1988
Kaplan, E.L.: Surgery of the Thyroid and Parathyroid Glands (Vol. 6). Edinburgh, Churchill Livingstone, 1983, pp. 262–274
Halsted, W.S., Evans, H.M.: The parathyroid glandules: their blood supply, and their preservation in operation upon the thyroid gland. Ann. Surg. 46:489, 1907
Curtis, G.M.: The blood supply of the human parathyroids. Surg. Gynecol. Obstet. 51:805, 1930
Tsuchiya, M. (ed.): Microcirculation, an Update (vols. 1 and 2). Amsterdam, Elsevier, 1987
Ahn, H., Lindhagen, J., Nilsson, G.E., Salerud, E.G., Jodal, M., Lundgren, O.: Evaluation of laser Doppler flowmetry in the assessment of intestinal blood flow in cat. Gastroenterology 88:951, 1985
Ahn, M., Johansson, K., Lundgren, O., Nilsson, G.E.: In vivo evaluation of signal processors for laser Doppler tissue flowmeters. Med. Biol. Eng. Comput. 25:207, 1987
Johanson, K., Ahn, M., Lindhagen, J., Lundgren, O., Nilsson, G.E.: Tissue penetration and measuring depth of laser Doppler flowmetry in the gastrointestinal application. Scand. J. Gastroenterol. 22:1081, 1987
Nilsson, G.E., Tenland, I., Öberg, P.Å.: A new instrument for continuous measurement of tissue blood flow by light beating spectroscopy. J. E.E.E. Trans. Biomed. Eng. 27:12, 1980
Nilsson, G.E., Tenland, I., Öberg, P.Å.: Evaluation of laser Doppler flowmeter for measurement of tissue blood flow. J. E.E.E. Trans. Biomed. Eng. 27:597, 1980
Jörtsö, E., Lennquist, S., Lundström, B., Norrby, K., Smeds, S.: The influence of remnant size, antithyroid antibodies, thyroid morphology and lymphocyte infiltration on thyroid function after subtotal resection for hyperthyroidism. World J. Surg. 11:365, 1987
Caspary, L., Crentzig, A., Alexander, K.: Biological zero in laser Doppler fluxmetry. Int. J. Microcirc. Clin. Exp. 7:367, 1988
Johansson, K., Ahn, H., Kjellström, C., Lindhagen, J.: Laser Doppler flowmetry in experimental mesenteric vascular occlusion. Int. J. Microcirc. Clin. Exp. 10:19, 1991
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johansson, K., Ander, S., Lennquist, S. et al. Human parathyroid blood supply determined by laser-Doppler flowmetry. World J. Surg. 18, 417–420 (1994). https://doi.org/10.1007/BF00316825
Issue Date:
DOI: https://doi.org/10.1007/BF00316825