Comparative Study of Parathyroid Identification Techniques Using Zuckerkandl's Tubercle Versus Parathyroid Arterial...

Area of Science:

• Otolaryngology
• Surgical Anatomy
• Endocrine Surgery

Background:

• Parathyroid gland damage is a significant complication during thyroidectomy.
• Accurate identification of parathyroid glands is crucial for preventing hypoparathyroidism.
• Current methods using thyroid artery landmarks have limitations in reliability.

Purpose of the Study:

• To compare Zuckerkandl's Tubercle (ZT) with superior thyroid artery (STA) and inferior parathyroid artery (ITA) for parathyroid gland localization.
• To outline operative steps for identifying ZT during thyroidectomy.
• To assess the impact of ZT identification on parathyroid gland preservation.

Main Methods:

• A prospective observational study involving 36 thyroidectomy cases.
• Group A: Parathyroid identification based on STA and ITA.
• Group B: Parathyroid identification based on ZT.
• Surgical steps, gland location, preservation, and anatomical relations were recorded.

Main Results:

• Group B (ZT) showed a higher rate of successful parathyroid identification and preservation (93.75%) compared to Group A.
• Superior parathyroid glands (SPT) were typically located cranial to ZT.
• Inferior parathyroid glands (IPT) showed variable location but were less frequently associated with ZT compared to ITA.

Conclusions:

• Zuckerkandl's Tubercle (ZT) significantly enhances the reliability of parathyroid gland localization during thyroidectomy.
• Utilizing ZT as a landmark improves the rate of parathyroid gland preservation.
• Detailed operative steps for ZT identification can guide surgeons in minimizing parathyroid damage.