In Vivo Staining of the Parathyroid Glands

SELECTIVE, in vivo staining of the parathyroid glands using intravenous and intraarterial administration of toluidine blue has been previously described in dogs.1,2Clinical studies have been limited to one series of five human subjects to whom toluidine blue was administered intra-arterially, with selective parathyroid staining occurring in three cases.2 Presented in this paper is a report on the intravenous and intra-arterial use of toluidine blue in 32 human subjects for the purpose of determining its place in the gross identification of the parathyroid glands during surgery. Methods and Materials All patients who were selected for this study, with the exception of one, were undergoing surgery for either thyroid neoplasm or toxic goiter. One patient had surgery for a functioning parathyroid adenoma (Table). Toluidine blue was prepared as a pyrogenfree 1% solution in normal saline. Twenty-seven patients received the dye solution intravenously via an antecubital vein, in doses ranging