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The missing thyroid.

Cord Sturgeon1, Carlos Corvera, Orlo H Clark

  • 1Division of GI/Endocrine Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Journal of the American College of Surgeons
|November 29, 2005
PubMed
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Failure to locate the thyroid during surgery, often due to low neck incisions or prior neck operations, necessitates improved surgical understanding. This impacts thyroidectomy outcomes.

Area of Science:

  • Endocrine Surgery
  • Surgical Anatomy

Background:

  • Patients referred after failed thyroidectomy attempts where the thyroid gland was not found.
  • Review aimed to identify factors contributing to missed or inadequately resected thyroid glands.

Purpose of the Study:

  • To analyze factors associated with the failure to identify or resect the thyroid gland during attempted thyroidectomy.

Main Methods:

  • Retrospective review of seven patients referred for a "missed thyroid" between 1990 and 2002.
  • Analysis of surgical indications, prior neck operations, complication recognition, incision sites, and intraoperative/pathologic findings.

Main Results:

  • Thyroid missed in initial or subsequent neck explorations.
  • Surgeons misidentified thymus or nodal tissue as thyroid.

Related Experiment Videos

  • Thyroid unidentifiable or unresectable due to scar tissue.
  • Inadequate thyroidectomy performed in some cases.
  • Low cervical incisions noted in patients with long necks.

    • Conclusions:

    • Low cervical incisions and prior neck surgery are linked to failure in thyroid gland identification.
    • Highlights the need for enhanced understanding of thyroid anatomy, embryology, localization, and surgical techniques.