# Application of Near-Infrared Fluorescence With Indocyanine Green in Head and Neck Surgery: Advantages and Unexpected Findings From an Initial Experience in Mexico City

## TL;DR

This paper explores the use of near-infrared fluorescence with indocyanine green in head and neck surgeries, highlighting its benefits and unexpected observations in Mexico City.

## Contribution

The study provides new insights into the application of fluorescence-guided surgery in complex head and neck procedures in a specific geographic context.

## Key findings

- Fluorescence-guided surgery using ICG successfully identified 50 parathyroid glands and other structures.
- Unexpected fluorescence was observed in nerves and the thoracic duct during surgeries.
- The technique enhanced surgical safety and provided additional benefits in complex procedures.

## Abstract

Background: Fluorescence-guided surgery (FGS) using indocyanine green (ICG) for fluorescent angiography and lymphography is well established as a safe and reproducible technique in head and neck surgery, mostly for thyroid and parathyroid surgery.

Methods: We present our experience with FGS for thyroid and parathyroid gland (PG), and other complex surgeries in the head and neck region, such as major gland resections, lymph node dissections, and carotid body tumor resections, among others.

Results: A total of 33 patients underwent FGS using ICG in different doses. A total of 50 PGs were identified; two carotid paragangliomas, two major salivary glands, the thoracic duct, and its right side equivalent were observed emitting fluorescence through the supraclavicular hollow. Twenty-one nerves were also observed emitting fluorescence.

Conclusions: FGS proved to be an excellent tool for additional surgical-related benefits and surgical safety in head and neck surgery, especially in complex procedures.