NEAR-INFRARED MAPPING OF RECURRENT LARYNGEAL NERVE BY FLUORENSCENCE-GUIDED SURGERY USING INDOCYANINE GREEN ANGIOGRAPHY andrii.dinets@gmail.com

396-04

NEAR-INFRARED MAPPING OF RECURRENT LARYNGEAL NERVE BY FLUORENSCENCE-GUIDED SURGERY USING INDOCYANINE GREEN ANGIOGRAPHY

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Ukraine

Oral or Poster

The recurrent laryngeal nerve (RLN) damage and parathyroid gland injury are the most severe complications of thyroid surgery. The possibility of RLN confirmation in the near-infrared spectrum after the injection of indocyanine green (ICG) was not yet been evaluated. This study aimed to evaluate the ICG angiography for the identification of RLN during thyroid and parathyroid surgery.

ICG angiography of RLN was performed in 7 patients. An intraoperative neuromonitoring (IONM) was applied as a method of controlling RLN. During the operation, parathyroid glands and RLN were identified by visual inspection (naked eye). To further confirm the location of the parathyroid glands by their autofluorescence, an intravenous injection of ICG was performed with a concentration of 0.25 mg/kg followed by the application of the Fluoptics 800 (Fluobeam) image-based system. A good signal was achieved in the near-infrared spectrum from the RLN in all cases after the ICG injection.

Sufficient blood perfusion of the RLN could be considered as a reasonable explanation for the exhibition of a good ICG near-infrared signal in all 7 patients. ICG application might be considered as a helpful approach for the confirmation of the RLN in addition to routine visual identification. Such a feature could be applied during fluorescence-guided surgery for evaluation of the parathyroid glands autofluorescence.

Visualization of RLN by ICG angiography might be considered as an additional useful tool to prevent its injury.