Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, 9669 North Kenton Avenue, Suite 206, Skokie, IL 60076, USA.
Department of Surgery, Thyroid Surgery Unit, Gustave Roussy Cancer Campus and University Paris-Saclay, 114 rue Edouard Vaillant, Villejuif, Paris 94805, France.
Otolaryngol Clin North Am. 2024 Feb;57(1):139-154. doi: 10.1016/j.otc.2023.07.011. Epub 2023 Aug 25.
Postoperative hypoparathyroidism may cause significant patient morbidity and even mortality. Emerging technologies centered on autofluorescent properties of parathyroid glands when exposed to near-infrared light hold promise to improve surgical parathyroid gland identification and preservation. Two systems (probe-based and camera-based) are commercially available currently; however, neither system alone provides indication of vascular viability or postoperative parathyroid gland function. The administration of indocyanine green, when combined with near-infrared fluorescence imaging, enables subjective assessment of parathyroid gland perfusion. Additional technologies to assess parathyroid gland perfusion are being developed. The impact of these nascent technologies on relevant clinical outcomes is an area of active investigation.
术后甲状旁腺功能减退症可能导致患者出现严重的发病率,甚至死亡率。目前有一些新兴技术,主要利用甲状旁腺在近红外光下的自发荧光特性,有望提高手术中甲状旁腺的识别和保护。目前有两种系统(基于探头和基于相机)商业化应用;然而,没有任何一种系统可以单独提供血管活力或术后甲状旁腺功能的指示。吲哚菁绿的应用,结合近红外荧光成像,可以实现对甲状旁腺灌注的主观评估。目前正在开发评估甲状旁腺灌注的其他技术。这些新兴技术对相关临床结局的影响是一个活跃的研究领域。