Thyroid tubercle of Zuckerkandl: anatomical and surgical experience from 79 thyroidectomies

@article{Page2008ThyroidTO,
  title={Thyroid tubercle of Zuckerkandl: anatomical and surgical experience from 79 thyroidectomies},
  author={Cyril Page and Philippe Cuvelier and Aur{\'e}lie Biet and P Bout{\'e} and Maurice Laude and Vladimir Strunski},
  journal={The Journal of Laryngology \& Otology},
  year={2008},
  volume={123},
  pages={768 - 771},
  url={https://api.semanticscholar.org/CorpusID:22063700}
}
The tubercle of Zuckerkandl is a poorly known and variable anatomical feature of the thyroid gland which may not, in fact, be so rare and can be a reliable anatomical landmark for identifying the recurrent laryngeal nerve during thyroid surgery.
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41 Citations
Highly Influential Citations
4
Background Citations
15
Methods Citations
1

41 Citations

SURGICAL ANATOMY OF THYROID TUBERCLE OF ZUCKERKANDL

Zuckerkandl Tubercle of the Thyroid: A Common Imaging Finding That May Mimic Pathology

Recognition of this feature of the thyroid gland at CT imaging can obviate the need for biopsy and avoid potential recurrent laryngeal nerve injury.

Importance of Tubercle of Zuckerkandl in Thyroid Surgery

Recurrent Laryngeal Nerve was identified with the help of inferior thyroid artery (ITA) and Zuckerkandl tubercle in 68% of cases for safety and RLN could be safeguarded with theHelp of of ZT in this series of cases along with ITA.

The Tubercle of Zuckerkandl is Associated with Increased Rates of Transient Postoperative Hypocalcemia and Recurrent Laryngeal Nerve Palsy After Total Thyroidectomy.

The tubercle of Zuckerkandl, when present and of significant macroscopic size is associated with increased rates of transient postoperative hypocalcemia and recurrent laryngeal nerve palsy.

The Rare Coincidence: Nonrecurrent Laryngeal Nerve Pointed by a Zuckerkandl's Tubercle

Based on anatomical and embryological variations, it is suggested identification and full exposure of ILN before attempting excision of adjacent structures, like the ZT which has surgical importance for completeness of thyroidectomy.

Two Cases of Enlarged Zuckerkandl's Tubercle of the Thyroid Displacing the Recurrent Laryngeal Nerve Laterally

The knowledge of the anatomy of ZT and its relation with the RLN including all variations is mandatory for safe thyroid operations.

Zuckerkandl Tubercle of the Thyroid Gland: Correlations between Findings of Anatomic Dissections and CT Imaging

Zuckerkandl tubercles that protrude toward the posteromedial and superior or inferior direction could cause confusion due to their separation when performing diagnoses with CT images.

Incidence of tubercle of Zuckerkandl of the thyroid and it’s surgical relation with recurrent laryngeal nerve and the superior parathyroid gland

Zuckerkandl’s tubercle is a posterior extension of lateral lobes of the thyroid gland, maintains a constant relationship with the RLN and the superior parathyroid gland during thyroid surgery.

Incidence and Surgical Importance of Zuckerkandl's Tubercle of the Thyroid and Its Relations with Recurrent Laryngeal Nerve

RLN is unusually laying lateral to ZT which is common structure in the thyroid, and may be more vulnerable to injury, and should be fully isolated before excision of adjacent structures.

The use of Zuckerkandl's tubercle as an anatomical landmark in identifying recurrent laryngeal nerve and superior parathyroid gland during total thyroidectomy: a prospective single-surgeon study

The ZT can be used as a reliable and constant landmark to localize both the RLN and the SPG during thyroid surgery, which enables minimizing the risk of iatrogenic injury to RLN, while ensuring a parathyroid-sparing thyroidectomy.

19 References

Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery.

The TZ is a distinct feature of the thyroid gland that can be recognised during most thyroidectomies and has no constant relationship to preoperative symptoms.

The cricothyroid space: a guide for successful thyroidectomy.

Zuckerkandl's tubercle of the thyroid gland in association with pressure symptoms: a coincidence or consequence?

Observations in the present study supported a strong association of enlarged ZT with pressure symptoms, and it is believed that in a relatively small-size goitre the ZT may cause significant pressure symptoms.

The inferior laryngeal nerve: surgical and anatomic considerations. Report of 251 thyroidectomies

The inferior laryngeal nerve is characterized by its important anatomic variations, especially on the right side, and these variations might be different even between males and females.

Superior approach to the inferior laryngeal nerve in thyroid surgery: anatomy, surgical technique and indications

The anatomical bases of the surgical access to the higher part of the thyroid lobe, with first location and complete dissection of the inferior laryngeal nerve are described to discuss the advantages and disadvantages of this surgical technique and to determine the operational indications.

Zuckerkandl's tuberculum: an arrow pointing to the recurrent laryngeal nerve (constant anatomical landmark)

The recurrent laryngeal nerve related to thyroid surgery.

The use of the inferior cornu of the thyroid cartilage in identifying the recurrent laryngeal nerve.

In a study of 500 recurrent laryngeal nerves, the inferior cornu of the thyroid cartilage was more reliable than the inferior thyroid artery in identifying the recurrent lickengeal nerve.

Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve.

A safe technique for thyroidectomy with complete nerve dissection and parathyroid preservation.

A series of 1,000 consecutive thyroid operations is presented, without a case of permanent recurrent laryngeal nerve injury, due in part to the avoidance of ligating the inferior thyroid artery in continuity and the technique of extracapsular dissection of the thyroid gland.