Department of Otolaryngology-Head & Neck Surgery, Stanford University, California, Palo Alto, USA.
Department of Surgery, Division of Pediatric Surgery, Stanford University, California, Palo Alto, USA.
Otolaryngol Head Neck Surg. 2023 Jul;169(1):185-189. doi: 10.1002/ohn.272. Epub 2023 Jan 29.
Devices for near-infrared light stimulation of autofluorescence (NIRAF) allow for intraoperative identification of parathyroid glands with high sensitivity in adults. However, their performance in the pediatric population is unknown. In this case series with chart review at a tertiary academic children's hospital, we investigated pediatric patients undergoing thyroid surgery and concurrent use of a probe-based NIRAF device. Thirteen patients (ages 6-18 years) underwent thyroid and/or neck dissection procedures, and 2 patients had revision procedures for a total of 15 cases with the NIRAF device. Eight cases had NIRAF values that matched surgeon opinion of parathyroid tissue or histology when available. Six cases had false positive NIRAF readings (40.0%) and 1 case had false negative readings (6.7%). Compared with surgeon opinion or histology, the NIRAF device confirmed 26 of 34 parathyroid gland candidates (76.5%). These devices need further investigation in pediatric patients, whose tissues may have different autofluorescence characteristics.
近红外光激发自体荧光（NIRAF）设备可在成人中实现甲状旁腺的高灵敏度术中识别。然而，其在儿科人群中的性能尚不清楚。在这项三级学术儿童医院的病例系列和图表回顾研究中，我们调查了接受甲状腺手术和同时使用基于探头的 NIRAF 设备的儿科患者。13 名患者（6-18 岁）接受了甲状腺和/或颈部解剖手术，2 名患者进行了翻修手术，共有 15 例使用了 NIRAF 设备。8 例 NIRAF 值与外科医生对甲状旁腺组织或组织学的意见相符（当有组织学结果时）。6 例出现假阳性 NIRAF 读数（40.0%），1 例出现假阴性读数（6.7%）。与外科医生的意见或组织学相比，NIRAF 设备确认了 34 名甲状旁腺候选者中的 26 名（76.5%）。这些设备需要在儿科患者中进一步研究，因为他们的组织可能具有不同的自体荧光特征。
