Protection of Parathyroid Function Using Carbon Nanoparticles during Thyroid Surgery

Abstract

Objective To investigate the hypothesis that injected carbon nanoparticle (CN) suspension helps identify parathyroid glands (PGs) during thyroid cancer surgery, thereby reducing PG injury. Study Design A prospective, randomized controlled trial. Setting Sun Yet-san Memorial Hospital, Guangzhou, China. Subjects and Methods Thyroid cancer surgeries were performed on 72 consenting patients who were randomized for conventional surgery (control group) or surgery with CN suspension injection (CN group). The primary end point was the prevalence of symptomatic hypocalcemia and serum calcium levels <1.9 mmol/L. Results From 36 patients diagnosed with thyroid cancer in each group, symptomatic hypocalcemia was found in 10 patients without CN injection and 3 patients with CN suspension injection ( P = .032). In total, 5.6% of patients in the CN group presented with muscle cramps compared with 22.2% of the control group ( P = .041), which showed a significant difference. Conclusion Our randomized study revealed that CN suspension injection was feasible and appeared to be beneficial for patients undergoing thyroid surgery because the incidence of symptomatic hypocalcemia was lower compared with controls. Therefore, this technology and technique should be more widely considered for thyroid cancer therapy. Additional studies with more patients and longer follow-up times will be needed for a thorough evaluation of this methodology.