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The false thyroid capsule: new findings

Published online by Cambridge University Press:  08 August 2013

Y-H Tan ,
G-N Du ,
Y-G Xiao ,
S-Q Guo ,
T Wu ,
P-Z Chen ,
G-B Yan ,
D-X Tan  and
K Wang
Y-H Tan
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
G-N Du
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
Y-G Xiao*
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
S-Q Guo
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
T Wu
Affiliation:
Department of Anatomy, the Southern Medical University, Guangzhou, People's Republic of China
P-Z Chen
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
G-B Yan
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
D-X Tan
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
K Wang
Affiliation:
Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan, People's Republic of China
*
Address for correspondence: Dr Yu-Gen Xiao, Department of Thyroid and Breast Surgery, Affiliated Nanhai Hospital of Southern Medical University, 40 Fo Ping Rd, Foshan 528200, PR China E-mail: tyh-lee@hotmail.com
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Abstract

Purpose:

The false thyroid capsule is an important anatomical structure involved in thyroidectomy, yet it is rarely studied. This study aimed to define the anatomy of the false thyroid capsule, and its clinical significance.

Methods:

A prospective study was performed involving 151 patients with goitre who underwent thyroid lobectomy. The anatomy of the false thyroid capsule was carefully documented intra-operatively.

Results:

The false thyroid capsule enclosed the inferior and middle thyroid veins and the superior thyroid vessels, forming a mesentery-like structure by attaching to the gland. Once the unilateral lobe had been removed, the thyroid mesentery could be seen to have a C-shaped edge. The recurrent laryngeal nerve, inferior thyroid artery and parathyroid glands were located beneath the C-shaped edge of the thyroid mesentery.

Conclusion:

The thyroid mesentery is a distinctive structure that can be used as a guide for surgical dissection.

Keywords

ThyroidAnatomyRecurrent Laryngeal NerveThyroidectomy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 897 - 901
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Bliss, RD, Gauger, PG, Delbridge, LW. Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg 2000;24:891–7Google Scholar
2Delbridge, L. Total thyroidectomy: the evolution of surgical technique. A N Z J Surg 2003;73:761–8Google Scholar
3Sakorafas, GH. Historical evolution of thyroid surgery: from the ancient times to the dawn of the 21st century. World J Surg 2010;34:1793–804Google Scholar
4Gemsenjaeger, E. Atlas of Thyroid Surgery: Principles, Practice, and Clinical Cases. New York: Thieme, 2008;9–23Google Scholar
5Serpell, JW, Grodski, S, Yeung, M, Swann, J, Kemp, S, Johnson, W. Hemithyroidectomy: a heuristics perspective. A N Z J Surg 2008;78:1122–7Google Scholar
6Pool, EH, Falk, HC. Concerning the surgical anatomy of the thyroid with special reference to the parathyroid. Ann Surg 1916;63:71–7Google Scholar
7Yerzingatsian, KL. Thyroidectomy under local analgesia: the anatomical basis of cervical blocks. Ann R Coll Surg Engl 1989;71:207–10Google Scholar
8Cernea, CR, Nishio, S, Hojaij, FC. Identification of the external branch of the superior laryngeal nerve (EBSLN) in large goiters. Am J Otolaryngol 1995;16:307–11Google Scholar
9Cernea, CR, Ferraz, AR, Nishio, S, Dutra, A, Hojaij, FC, Medina dos Santos, LR. Surgical anatomy of the external branch of the superior laryngeal nerve. Head Neck 1992;14:380–3Google Scholar
10Gauger, PG, Delbridge, L, Thompson, N, Crummer, P, Reeve, TS. Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery. Eur J Surg 2001;167:249–54Google Scholar
11Sheahan, P, Murphy, MS. Thyroid tubercle of Zuckerkandl: importance in thyroid surgery. Laryngoscope 2011;121:2335–7Google Scholar
12Wafae, N, Hirose, K, Franco, C, Wafae, GC, Ruiz, CR, Daher, L et al. The anatomy of the human thyroid veins and its surgical application. Folia Morphol (Warsz) 2008;67:221–5Google Scholar
13Abboud, B, Sleilaty, G, Braidy, C, Zeineddine, S, Ghorra, C, Abadjian, G et al. Careful examination of thyroid specimen intraoperatively to reduce incidence of inadvertent parathyroidectomy during thyroid surgery. Arch Otolaryngol Head Neck Surg 2007;133:1105–10Google Scholar
14Skandalakis, JE. Anatomical Complications in General Surgery. New York: McGraw-Hill, 1983;11Google Scholar
15Rix, TE, Sinha, P. Inadvertent parathyroid excision during thyroid surgery. Surgeon 2006;4:339–42Google Scholar
16Akerstrom, G, Malmaeus, J, Bergstrom, R. Surgical anatomy of human parathyroid glands. Surgery 1984;95:14–21Google Scholar
17Ardito, G, Revelli, L, D'Alatri, L, Lerro, V, Guidi, ML, Ardito, F. Revisited anatomy of the recurrent laryngeal nerves. Am J Surg 2004;187:249–53Google Scholar
18Serpell, JW. New operative surgical concept of two fascial layers enveloping the recurrent laryngeal nerve. Ann Surg Oncol 2010;17:1628–36Google Scholar
19Sasou, S, Nakamura, SI, Kurihara, H. Suspensory ligament of Berry: its relationship to recurrent laryngeal nerve and anatomic examination of 24 autopsies. Head Neck 1998;20:695–8Google Scholar
20Nordland, M. The larynx as related to surgery of the thyroid based on an anatomic study. Surg Gynecol Obstet 1930;51:449–59Google Scholar
21Page, C, Foulon, P, Strunski, V. The inferior laryngeal nerve: surgical and anatomic considerations. Report of 251 thyroidectomies. Surg Radiol Anat 2003;25:188–91Google Scholar
22Chiang, FY, Lu, IC, Kuo, WR, Lee, KW, Chang, NC, Wu, CW. The mechanism of recurrent laryngeal nerve injury during thyroid surgery – the application of intraoperative neuromonitoring. Surgery 2008;143:743–9Google Scholar
23Reeve, T, Thompson, NW. Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg 2000;24:971–5Google Scholar
24Snyder, SK, Lairmore, TC, Hendricks, JC, Roberts, JW. Elucidating mechanisms of recurrent laryngeal nerve injury during thyroidectomy and parathyroidectomy. J Am Coll Surg 2008;206:123–30Google Scholar