Radioactive iodine-125 seed localization as an aid in reoperative neck surgery

Scarring and disrupted tissue planes add to already-complex neck anatomy and make localization of nonpalpable pathology difficult in cervical endocrine reoperations. We describe the use of radioactive iodine-125 seed localization (RSL) in 6 patients with metastatic papillary thyroid carcinoma (PTC) and 2 with recurrent hyperparathyroidism. Eight patients had 2-D ultrasound-guided RSL of the target lesion, 0–3 days preoperatively. Intraoperative gamma probe (Neoprobe) was used to plan incision placement and localize the implanted seed. Recorded operative variables included: number of lymph nodes (LNs) harvested, estimated blood loss (EBL), operative time, length of stay (LOS) and RSL and operative complications. All patients had successful resection of the targeted area and removal of the radioactive seed. There was no seed migration. Two complications occurred in the thyroid group. Radioactive iodine 125 seeds facilitate successful localization of endocrine pathology during reoperative cervical procedures. •Radioactive iodine 125 seed localization facilitates safe and efficient localization of endocrine pathology during reoperative cases.•This summarizes our experience with RSL for recurrent or persistent papillary thyroid carcinoma and with recurrent hyperparathyroidism.