Conventional surgical techniques versus intraoperative methylene blue spraying for safe total thyroidectomy

Background Thyroidectomy is one of the most surgical interventions in endocrine surgery. When the operation is performed in respective surgical centers, the operation is safe with low morbidity and ∼0% mortality. Patients and methods The study was a quasi‑experimental study carried out at Assiut University Hospital. One hundred patients with benign and malignant goiter disorders underwent primary (not recurrent) total thyroidectomy. The patients were assigned into two groups: group 1 (interventional group) included 50 cases operated upon with methylene blue spraying technique and group 2 (control group) 50 cases established with the conventional technique. Methylene blue was sprayed over the thyroid lobe and perilober area. Parathyroides and recurrent laryngeal nerve were identified and evaluated. Results Recurrent laryngeal nerve was not stained and remained white in all cases while all other tissues were stained blue. Three minutes later the parathyroid glands washed out the blue stain and regain their original yellow color. Thyroid gland wash‑out time was ∼15 min. Conclusion Methylene blue spraying is a new technique that allows identification of both parathyroid glands and recurrent laryngeal nerves. This technique is safe, effective, and technically feasible.