{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:50:55Z","timestamp":1787669455312,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rarely, during the endoscopic thyroidectomy, carbon dioxide (CO<jats:sub>2<\/jats:sub>) embolism may occur.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Case 1: A 65\u2010year\u2010old female who was seen with prolonged fatigue and generalized bone pain was diagnosed primary hyperparathyroidism (PHPT) based on her preoperative biochemical profile. Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) was planned.<\/jats:p><jats:p>Case 2: A 52\u2010year\u2010old male patient was seen with weakness and hepatosteatosis and was diagnosed PHPT based on the laboratory workup. TOEPVA was planned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After subplatysmal dissection with vascular tunnel probe, both of the patients developed severe bradycardia and hypotension leading to asystole during the CO<jats:sub>2<\/jats:sub> insufflation. The possibility of CO<jats:sub>2<\/jats:sub> embolism was considered and insufflation was terminated. After a successful cardiac massage, sinus rhythm returned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TOEPVA may develop CO<jats:sub>2<\/jats:sub> embolism leading to asystole during the CO<jats:sub>2<\/jats:sub> insufflation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26855","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T12:34:26Z","timestamp":1630931666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Transient asystole related to carbon dioxide embolism during transoral endoscopic parathyroidectomy vestibular approach"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7353-8245","authenticated-orcid":false,"given":"Nurcihan","family":"Aygun","sequence":"first","affiliation":[{"name":"Department of General Surgery, Sisli Hamidiye Etfal Teaching and Research Hospital University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"Sar\u0131demir","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Akdeniz University  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koray","family":"Bas","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Izmir Bozyaka Teaching and Research Hospital University of Health Sciences  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Tunca","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur","family":"Arici","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine Akdeniz University  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-1615","authenticated-orcid":false,"given":"Mehmet","family":"Uludag","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sisli Hamidiye Etfal Teaching and Research Hospital University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"VJ Orhurhu CC Gao C Ku Carbon Dioxide Embolism"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.15492"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102810"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2012.53.3.459"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-010-0992-4"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.174806"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25037"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26153"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2018.06.006"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2010.59.s.s137"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21812"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-016-0255-5"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.08.010"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26855","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.26855","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T20:58:03Z","timestamp":1692997083000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.26855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,6]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1002\/hed.26855"],"URL":"https:\/\/doi.org\/10.1002\/hed.26855","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,6]]},"assertion":[{"value":"2020-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}