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The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

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The Zuckerkandl tubercle: problematic or helpful in thyroid surgery?

Elisa Gil-Carcedo¹, María E Menéndez, Luis A Vallejo

¹Department of Otorhinolaryngology, Head and Neck Surgery, Rio Hortega Universtity Hospital (SACYL), University of Valladolid, Dulzaina, 2, 47012 Valladolid, Spain. e.gilcarcedo@gmail.com

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

|January 15, 2013

Summary

The Zuckerkandl tubercle, an embryological remnant, is a key surgical landmark for identifying parathyroid glands and the recurrent laryngeal nerve during thyroidectomies. Its presence aids in preserving vital structures, despite posing dissection challenges.

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Area of Science:

Anatomy
Surgical Anatomy
Embryology

Background:

The Zuckerkandl tubercle is an embryological remnant of the thyroid gland.
While known in general surgery, its significance is less recognized among otolaryngologists.

Purpose of the Study:

To emphasize the surgical importance of the Zuckerkandl tubercle.
To highlight its utility as a landmark for critical anatomical structures during thyroid surgery.

Main Methods:

Prospective analysis of the posterolateral border of 195 thyroid lobes from 107 thyroidectomies.
Surgical identification and documentation of the Zuckerkandl tubercle and related structures.

Main Results:

The Zuckerkandl tubercle was identified in 79.48% of thyroid lobes, more frequently on the right.
Its presence correlated with accurate localization of the upper parathyroid gland (95.23% right, 91.54% left).
The recurrent laryngeal nerve and lower thyroid artery were consistently found beneath the tubercle.

Conclusions:

The Zuckerkandl tubercle is a reliable anatomical landmark in thyroid surgery.
It aids in the precise identification and preservation of the recurrent laryngeal nerve and parathyroid glands.
Despite potential dissection difficulties, it is invaluable for safe thyroidectomies.