{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:44:08Z","timestamp":1791945848532,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Compared to adult patients undergoing thyroid surgery, pediatric patients have higher rates of hypoparathyroidism often related to parathyroid gland (PG) inadvertent injury or devascularization. Previous studies have shown that near\u2010infrared\u2010autofluorescence (NIRAF) can be reliably used intraoperatively for label\u2010free parathyroid identification, but all prior studies have been performed in adult patients. In this study, we assess the utility and accuracy of NIRAF with a fiber\u2010optic probe\u2010based system to identify PGs in pediatric patients undergoing thyroidectomy or parathyroidectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All pediatric patients (under 18\u2009years of age) undergoing thyroidectomy or parathyroidectomy were enrolled in this IRB\u2010approved study. The surgeon's visual assessment of tissues was first noted and the surgeon's confidence level in the tissue identified was recorded. A fiber\u2010optic probe was then used to illuminate tissues\u2010of\u2010interest with a wavelength of 785\u2009nm and resulting NIRAF intensities from these tissues were measured while the surgeon was blinded to results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      NIRAF intensities were measured intraoperatively in 19 pediatric patients. Normalized NIRAF intensities for PGs (3.63\u2009\u00b1\u20092.47) were significantly higher than that of thyroid (0.99\u2009\u00b1\u20090.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and other surrounding soft tissues (0.86\u2009\u00b1\u20090.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Based on the PG identification ratio threshold of 1.2, NIRAF yielded a detection rate of 95.8% (46\/48 pediatric PGs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that NIRAF detection can potentially be a valuable and non\u2010invasive technique to identify PGs during neck operations in the pediatric population. To our knowledge, this is the first study in children to assess the accuracy of probe\u2010based NIRAF detection for intraoperative parathyroid identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      Level 4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 133:3208\u20133215, 2023\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.30633","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T05:07:18Z","timestamp":1677820038000},"page":"3208-3215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Identifying Parathyroids in Pediatric Thyroid\/Parathyroid Surgery by Near Infrared Autofluorescence"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9490-3694","authenticated-orcid":false,"given":"Ryan H.","family":"Belcher","sequence":"first","affiliation":[{"name":"Vanderbilt Department of Otolaryngology \u2013 Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Division of Pediatric Otolaryngology Monroe Carrell Jr. Children's Hospital at Vanderbilt  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5910-8804","authenticated-orcid":false,"given":"Giju","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Vanderbilt University  Nashville Tennessee USA"},{"name":"Vanderbilt Biophotonics Center Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parker A.","family":"Willmon","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Vanderbilt University  Nashville Tennessee USA"},{"name":"Vanderbilt Biophotonics Center Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4696-2013","authenticated-orcid":false,"given":"Jean\u2010Nicolas","family":"Gallant","sequence":"additional","affiliation":[{"name":"Vanderbilt Department of Otolaryngology \u2013 Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naira","family":"Baregamian","sequence":"additional","affiliation":[{"name":"Vanderbilt Section of Surgical Sciences \u2013 Department of Surgery Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica E.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Section of Surgical Sciences Vanderbilt University Medical Center, Monroe Carrell Jr. Children's Hospital at Vanderbilt  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen C.","family":"Sol\u03ccrzano","sequence":"additional","affiliation":[{"name":"Vanderbilt Section of Surgical Sciences \u2013 Department of Surgery Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Mahadevan\u2010Jansen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Vanderbilt University  Nashville Tennessee USA"},{"name":"Vanderbilt Biophotonics Center Vanderbilt University  Nashville Tennessee USA"},{"name":"Vanderbilt Section of Surgical Sciences \u2013 Department of Surgery Vanderbilt University Medical 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