TOETVA parathyroid autofluorescence detection: hANDY-i endoscopy attachment

Stefanie Seo; Khalid Mohamed Ali; Samantha A. Wolfe; Nimesh V. Nagururu; Andy S. Ding; Dipan Desai; R. Alex Harbison; Yoseph Kim; Bo Ning; Richard Jaepyeong Cha; Richard Jaepyeong Cha; Richard Jaepyeong Cha; Jonathon O. Russell

doi:10.3389/fendo.2023.1233956

Frontiers in Endocrinology (Aug 2023)

TOETVA parathyroid autofluorescence detection: hANDY-i endoscopy attachment

Stefanie Seo,
Khalid Mohamed Ali,
Samantha A. Wolfe,
Nimesh V. Nagururu,
Andy S. Ding,
Dipan Desai,
R. Alex Harbison,
Yoseph Kim,
Bo Ning,
Richard Jaepyeong Cha,
Richard Jaepyeong Cha,
Richard Jaepyeong Cha,
Jonathon O. Russell

Affiliations

Stefanie Seo: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
Khalid Mohamed Ali: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
Samantha A. Wolfe: Department of Endocrine Surgery, University Health Network, Toronto, ON, Canada
Nimesh V. Nagururu: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
Andy S. Ding: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
Dipan Desai: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
R. Alex Harbison: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
Yoseph Kim: Department of Research, Optosurgical, LLC, Columbia, MD, United States
Bo Ning: Sheikh Zayed Institute, Children’s National Hospital, Washington, DC, United States
Richard Jaepyeong Cha: Department of Research, Optosurgical, LLC, Columbia, MD, United States
Richard Jaepyeong Cha: Sheikh Zayed Institute, Children’s National Hospital, Washington, DC, United States
Richard Jaepyeong Cha: Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
Jonathon O. Russell: Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States

DOI: https://doi.org/10.3389/fendo.2023.1233956
Journal volume & issue: Vol. 14

Abstract

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BackgroundTreatment options for thyroid pathologies have expanded to include scarless and remote access methods such as the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Currently, no standardized methods exist for locating parathyroid glands (PGs) in patients undergoing TOETVA, which can lead to parathyroid injury and subsequent hypocalcemia. This early feasibility study describes and evaluates the hANDY-i endoscopic attachment for detecting PGs in transoral thyroidectomy.MethodsWe used a prototype parathyroid autofluorescence imager (hANDY-i) that was mounted to a 10-mm 0-degree endoscope. The device delivers a split screen view of Red-green-blue (RGB) and near-infrared autofluorescence (NIRAF) which allows for simultaneous anatomical localization and fluorescence visualization of PGs during endoscopic thyroid dissection.ResultsOne cadaveric case and two patient cases were included in this study. The endoscopic hANDY-i imaging system successfully visualized PGs during all procedures.ConclusionThe ability to leverage parathyroid autofluorescence during TOETVA may lead to improved PG localization and preservation. Further human studies are needed to assess its effect on postoperative hypocalcemia and hypoparathyroidism.

Published in Frontiers in Endocrinology

ISSN: 1664-2392 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.frontiersin.org/journals/endocrinology

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