Title: A Descriptive Study about the Cardinal Anatomical Structures to be Preserved during Thyroidectomy and tips for it
Author: Arun.S
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.102
Abstract
Background: Thyroidectomy is one of the most commonly performed procedure for both benign and malignant diseases of the thyroid. By developing a thorough understanding of anatomical landmarks and by making use of them, the surgeon can minimise the risk associated with the procedure. Experience of the surgeon is a significant factor in minimising or dealing with the complications. During each thyroidectomy, recurrent laryngeal, external branch of superior laryngeal nerves, and parathyroids should be routinely preserved. For this, various approaches like inferior, superior or lateral, tubercle of Zuckercandl, or landmarks like inferior thyroid artery, space of reeves may be used. The unidentified nerves are most likely to be damaged leading to high morbidity and rarely mortality. Transient or permanent hypoparathyroidism is due to inadvertent gland removal or injury to its vascular pedicle.
Aim: To analyse the cardinal anatomical structures to be preserved during each thyroidectomy and the tips for safeguarding them. Material and methods: This is an observational study of 75 thyroidectomies performed for various indications from 2016 December to 2018 December. Surgical details from case sheets and surgical register were perused for it. Patients on medical treatment for thyroid diseases were excluded.
Conclusions: The recurrent laryngeal nerve, external branch of superior laryngeal nerve and parathyroids are the cardinal structures to be preserved during each thyroidectomy. Inferior, superior or lateral approaches, tubercle of Zuckercandl, superior or inferior thyroid arteries, space of reeves may be used.
Keywords: External branch of superior laryngeal nerve, Parathyroids, Recurrent laryngeal nerve, Thyroidectomy, Tubercle of Zuckercandl.
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