Parathyroid surgery and methylene blue: A review with guidelines for safe intraoperative use |
| |
| Authors: | Geoffrey Pollack MD Aron Pollack MS Joel Delfiner MD John Fernandez MD |
| |
| Affiliation: | 1. Department of Otolaryngology and Head and Neck Surgery, St. Luke's–Roosevelt Hospital Center and the Department of Otolaryngology, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.;2. The State University of New York at Stony Brook, Stony Brook, St. Luke's–Roosevelt Hospital Center, New York, New York, U.S.A.;3. Department of Neurology, St. Luke's–Roosevelt Hospital Center, New York, New York, U.S.A.;4. Department of Surgery, St. Luke's–Roosevelt Hospital Center, New York, New York, U.S.A. |
| |
| Abstract: | ![]()
Methylene blue has been used to help facilitate parathyroid surgery for over 30 years. Its use has been widely considered both safe and cost effective. Twenty‐six cases of a toxic metabolic encephalopathy, however, have been reported with its use. As a result, some surgeons have stopped using this technique altogether. It is now known that methylene blue is a monoamine oxidase inhibitor. When combined with drugs that increase central serotonin neurotransmission, serotonin toxicity results. This is the cause of the encephalopathy described in the literature. A case report, review of the literature, and guidelines as to its proper use are presented so as to allow for safe parathyroid surgery. Laryngoscope, 2009 |
| |
| Keywords: | Methylene blue encephalopathy parathyroidectomy monoamine oxidase A monoamine oxidase inhibitor serotonin syndrome serotonin toxicity |
|
|
