Gamma probe identification of normal parathyroid glands during central neck surgery can facilitate parathyroid preservation

Background: We evaluated gamma probe identification (GPI) of sestamibi-labeled normal parathyroid glands during central neck surgery. Methods: GPI was judged to be helpful if it resulted in the identification of parathyroid glands not identified by direct inspection. Results: GPI was performed in 54 patients and was helpful in 20, including 9 patients in whom GPI identified intact parathyroid glands in vivo and 11 patients in whom GPI identified incidentally excised parathyroid glands ex vivo in the central neck dissection (CND) specimen. GPI was more commonly helpful in patients who underwent reoperation (9/16, 56%) compared with primary surgery (11/38, 29%; P = .04) and was more commonly helpful in patients who underwent CND (17/28, 61%) compared with thyroidectomy without CND (2/26, 8%; P < .0001). In 11 patients, normal parathyroid glands were salvaged by GPI from the ex vivo CND specimens and autografted. Conclusions: GPI is a relatively simple and effective technique that may help maximize parathyroid preservation.