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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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Related Experiment Video

Updated: Dec 29, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Parapharyngeal Dissection for Papillary Thyroid Cancer.

Justin Tran¹, Mark Zafereo¹

¹Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas.

Videoendocrinology

|February 7, 2020

Summary

Metastases to parapharyngeal lymph nodes are rare in papillary thyroid cancer. This study demonstrates a transcervical surgical technique for resecting a large parapharyngeal lymph node metastasis, offering a new video guide for surgeons.

Keywords:

lymph node metastases papillary thyroid cancer parapharyngeal space surgery transcervical

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Last Updated: Dec 29, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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Published on: September 15, 2023

Area of Science:

Head and Neck Surgery
Surgical Oncology
Endocrinology

Background:

Papillary thyroid cancer commonly metastasizes to lymph nodes, but parapharyngeal and retropharyngeal involvement is infrequent.
While small parapharyngeal lymph node metastases (<1 cm) may be managed non-surgically, larger nodes necessitate surgical intervention.
Surgical access to the parapharyngeal and retropharyngeal spaces can be achieved via transoral or transcervical approaches.

Purpose of the Study:

To illustrate the surgical technique for transcervical resection of a large parapharyngeal lymph node metastasis from papillary thyroid cancer.
To provide a detailed video demonstration of the anatomical structures and stepwise approach for this rare surgical scenario.
To highlight the importance of anatomical knowledge for safe and effective parapharyngeal space dissection.

Main Methods:

A case presentation of a 47-year-old female with a 2.5 cm parapharyngeal lymph node metastasis extending to the skull base.
Detailed description and video illustration of the transcervical surgical approach.
Identification and mobilization of key anatomical structures including the hypoglossal nerve, external carotid artery branches, sympathetic chain, and superior laryngeal nerve.

Main Results:

Successful en bloc resection of the metastatic parapharyngeal lymph node with its skull base attachments.
Clear visualization and preservation of critical neurovascular structures during the transcervical dissection.
This video represents the first peer-reviewed demonstration of a transcervical parapharyngeal lymph node resection.

Conclusions:

Transcervical excision of parapharyngeal and retropharyngeal lymph nodes is a viable surgical option for managing large metastases.
A comprehensive understanding of neck and parapharyngeal space anatomy is crucial for executing this procedure safely.
This technique requires meticulous dissection and careful retraction of surrounding structures for optimal patient outcomes.