[INCIDENCE AND SURGICAL IMPORTANCE OF PYRAMIDAL LOBE AND TUBERCLE OF THE THYROID GLAND: A PROSPECTIVE STUDY]

Area of Science:

• Anatomy
• Endocrinology
• Surgical Oncology

Background:

• The pyramidal lobe and tubercles are frequent anatomical variations of the thyroid gland.
• These variations have significant implications for thyroid surgery, particularly in total thyroidectomy procedures.

Purpose of the Study:

• To investigate the incidence and anatomical characteristics of the pyramidal lobe and tubercles in patients undergoing total thyroidectomy.
• To assess the clinical significance of these variations in relation to surgical landmarks like the recurrent laryngeal nerve and parathyroid glands.

Main Methods:

• A prospective study analyzing 342 patients who underwent total thyroidectomy between January 2009 and March 2015.
• Detailed examination of the incidence, location, and dimensions of the pyramidal lobe and tubercles.

Main Results:

• The pyramidal lobe was observed in 52.3% of patients, with a predilection for central and left-sided placement.
• Tubercles were present bilaterally in 14.9% and unilaterally in a significant proportion of patients.
• Associated presence of both variations occurred in 34% of patients, with no significant gender-based differences.
• The recurrent laryngeal nerve and upper parathyroid gland were consistently located relative to the tubercles, aiding surgical navigation.

Conclusions:

• Anatomical variations like the pyramidal lobe and tubercles are highly prevalent in patients undergoing thyroidectomy, occurring in over 80% of cases.
• Awareness of these variations is essential for surgeons to ensure safe and effective thyroid gland removal and parathyroid preservation.