Ultrasound-guided methylene blue dye injection for parathyroid localization in the reoperative neck

Background: The goal of this study was to review a single institution's experience using intraoperative ultrasound-guided (ioUSG) methylene blue dye injection for the localization and removal of enlarged parathyroid glands in patients with primary hyperparathyroidism and a history of previous neck surgery. Methods: We performed a retrospective review of nine consecutive patients who underwent reoperative parathyroidectomy using ioUSG methylene blue dye injection. Results: All patients had successful resolution of their hyperparathyroidism, with at least a 50 % decrease in intraoperative parathyroid hormone level after resection. One patient had transient recurrent laryngeal nerve paresis. There were no permanent recurrent laryngeal nerve injuries or cases of permanent hypoparathyroidism. Conclusions: Blue dye injection is a safe and effective method of localizing diseased parathyroid glands in the reoperative neck. © 2013 Société Internationale de Chirurgie.