Gamma probe identification of normal parathyroid glands during central neck surgery can facilitate parathyroid preservation

BACKGROUND: We evaluated gamma probe identification (GPI) of sestamibi-labeled normal parathyroid glands during central neck Surgery. METHODS: GPI was judged to be helpful if it resulted in the identification of parathyroid glands not identified by direct inspection. RESULTS: GPI was performed in 54 patients and was helpful in 20, including 9 patients in whom GPI identified intact parathyroid glands in vivo and I I patients in whom GPI identified incidentally excised parathyroid glands ex vivo in the central neck dissection (CND) specimen. GPI was more commonly helpful in patients who Underwent reoperation (9/16, 56%) compared with primary surgery (11/38, 29%; P = .04) and was more commonly helpful in patients Who underwent CND (17/28, 61%) compared with thyroidectomy without CND (2/26, 8%; P < .0001). In I I patients, normal parathyroid glands were salvaged by GPI from the ex vivo CND specimens and autografted. CONCLUSIONS: GPI is it relatively simple and effective technique that may help maximize parathyroid preservation. (C) 2008 Elsevier Inc. All rights reserved.