Parathyroid gland preservation and selective autotransplantation utilizing topical lidocaine in total thyroidectomy.
OBJECTIVE
To review a new technique during total thyroidectomy that facilitates parathyroid gland preservation and selective autotransplantation utilizing topical 2% plain lidocaine as a spasmolytic/vasodilator agent.


METHODS
Retrospective case series review at a university hospital.


METHODS
The study population comprised 100 consecutive patients (84 women and 16 men; mean age, 52 years) undergoing total thyroidectomy from January 2007 to December 2008. Interventions were: parathyroid glands (PGs) with signs of devascularization treated with a topical solution of 2% plain lidocaine in an attempt to restore blood flow before committing to autotransplantation.


RESULTS
The main outcome measure was the incidence of hypoparathyroidism. A total of 40 parathyroid glands were autotransplanted. None of the 100 patients developed permanent hypoparathyroidism. There were no adverse effects utilizing this technique.


CONCLUSIONS
In our experience, the use of lidocaine spasmolysis is a useful technique in thyroid surgery for salvaging devascularized PGs. Its utility as a selection method for PG autotransplantation incurs minimal risk or cost and might further reduce the incidence of permanent hypoparathyroidism. Further study is warranted.
Kuriloff
Daniel B
DB
Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA. kuriloff@nyhni.org
Kizhner
Victor
V
D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000008:administration & dosage*; D010280:Parathyroid Glands / Q000098:blood supply / Q000637:transplantation*; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D010276:Parasympatholytics; D014665:Vasodilator Agents; D008012:Lidocaine