Shamim M S, Soomro R, Moizuddin.
Role of Methylene blue infusion in per-operative localization of parathyroid glands.
J Pak Med Assoc Jan ;54(4):199-202.

All patients with biochemically proven primary HPT, undergoing surgery, were included. Demographic data, mode of admission, history, examination findings and provisional diagnoses were recorded. Sestamibi scan was performed on each patient prior to next exploration. All patients underwent bilateral neck exploration. Transfusion of 20ml of sterile 2% solution of methylene blue in 500ml of 0.9% saline was started 15 to 30 minutes prior to induction and continued till the time of incision. On exploration the parathyroid glands to be excised were examined by primary author for change in color compared to surrounding tissue, which does not take-up methylene blue. Change in color was reated on a methylene blue infusion scoring scale (MISS). After end of study, findings of the Sestamibi scan and per-operative localization of the parathyroid glands by methylene blue were compared. Surgery was performed in 5 patients (2 males, 3 females). Sestamibi scan done in all 5 paients showed a single hyperfunctioning gland in 3 of them. All were reported as an adenoma after histopathological examination. A young boy with Multiple Endocrine Neoplasia type 1 (MEN-1) showed hyperfunction of all 4 glands on Sestamibi scan. A total of 8 glands were removed from 5 patients, four out of 8 showed an excellent uptake of methylene blue (MISS-3), 3 of them showed a good uptake (MISS-2), while one gland did not show any significant uptake (MISS-1, this was the last of the explored glands in the patient with MEN syndrome).

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How we can obtain sterlised Methyleneblue o
Posted by: javedswati on May 2005

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