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Thyroid tubercle of zuckerkandl: Importance in thyroid surgery

Authors


  • The authors have no financial disclosures for this article.

  • The authors have no conflicts of interest to disclose.

Abstract

Objective:

The Tubercle of Zuckerkandl (TZ), which is the remant of the lateral thyroid process, is an important anatomic structure that serves as a reliable landmark for the recurrent laryngeal nerve in thyroid surgery. Furthermore, removal of the TZ is critical for the adequate performance of a total thyroidectomy. However, there is little mention of the TZ in surgical textbooks or papers.

Methods:

Prospective observational study of 138 consecutive thyroid surgeries. The presence of the TZ, its size, and relationship to the recurrent laryngeal nerve, were recorded.

Results:

A total of 211 thyroid lobes were included in the study. The TZ was identified in 61.1% of all thyroid lobes. The median size was 8 mm (range = 3–40 mm). A TZ was more commonly identified on the right (69.6%) than on the left side (53.2%) (P = .02). The recurrent laryngeal nerve was found deep to the TZ in 98.4% of cases.

Conclusions:

A TZ is present in the majority of thyroid lobes. Awareness of the TZ is critical in performing an adequate total thyroidectomy, and is very useful as a landmark for the recurrent laryngeal nerve.

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