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A novel study for fluorescence patterns of the parathyroid glands during surgery using a fluorescence spectroscopy system

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Recently it was reported that the parathyroid glands (PGs) emit autofluorescence when exposed to near infrared light, and a technique using fluorescence to detect the PGs intraoperatively was found to be useful. In some cases, however, it was difficult to detect the PGs. We sought to clarify the situation regarding such undetectable cases.

Methods

The study comprised 45 patients (50 sides) who underwent thyroid or parathyroid surgery at Kushiro city general hospital between November 2018 and June 2019. We searched for the PGs intraoperatively using a fluorescence spectroscopy system. We statistically considered the factors related to the fluorescence patterns of background in cases in which two PGs could not be confirmed using Fisher’s exact test. Factors included age, gender, body-mass index, laterality, disease state, renal function, and comorbidity.

Results

In 41 sides (82%) fluorescence from at least one PG was determined. There was no significant difference in the detection rates among the other clinical factors. A “White out” pattern in which the background was too bright to detect PGs was observed in 11 sides (22%), and a “Black out” pattern in which the background and PGs were dark was observed in 18 sides (36%). Malignant disease was statistically associated with a “White out” pattern. No factors were found to be related to the “Black out” pattern.

Conclusion

In malignant disease, we should use this novel approach carefully.

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Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Kushiro City General Hospital, 1-12, Shunkodai, Kushiro, 085-0822, Japan

    Hiroshi Idogawa & Tomohiro Sakashita

  2. Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Akihiro Homma

Authors
  1. Hiroshi Idogawa
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  2. Tomohiro Sakashita
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  3. Akihiro Homma
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Corresponding author

Correspondence to Hiroshi Idogawa.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Idogawa, H., Sakashita, T. & Homma, A. A novel study for fluorescence patterns of the parathyroid glands during surgery using a fluorescence spectroscopy system. Eur Arch Otorhinolaryngol 277, 1525–1529 (2020). https://doi.org/10.1007/s00405-020-05849-4

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  • DOI: https://doi.org/10.1007/s00405-020-05849-4

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