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Developmental Anatomy of the Thyroid and Parathyroid Glands
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
The thyroid gland is situated in the lower anterior neck straddling the upper trachea. It is the largest endocrine organ in the body. It weighs 15–20g in adulthood.12, 13 It is a highly vascular, reddish-brown, bi-lobed structure with each lobe joined together by a narrow isthmus (Figure 53.1). Each lobe is pear-shaped, measuring approximately 5 cm in length, 3 cm in width and 1.5 cm in depth. The apex of each lobe is narrow and extends beneath the sternothyroid muscle up to its insertion on the oblique line of the thyroid cartilage. The more rounded lower pole extends down to the level of the fourth or fifth tracheal ring. It lies lateral to the trachea and oesophagus and medial to the carotid sheath. The isthmus overlies the second to fourth tracheal rings.
Head and neck
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Attachments of sternothyroid muscle– origin: manubrium– insertion: thyroid cartilage– nerve SS: ansa cervicalis C1–3– function: depress larynx
The thyroid gland
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Subplatysmal flaps are raised to an extent that allows access to the goitre, often from thyroid notch to sternal notch. The midline is identified between the strap muscles. The plane is developed to dissect between the muscle layers, elevating sternohyoid laterally until ansa cervicalis is visualised. The sternothyroid muscle is then mobilised from the gland, taking great care with the delicate vasculature. If required, the strap muscles may be divided superiorly to afford greater exposure.
Anatomical and functional identification of the external branch of the superior laryngeal nerve: classification based on morphology and electrophysiological monitoring
Published in Acta Chirurgica Belgica, 2022
The sternothyroid muscle was retracted at the upper level and laterally during upper pole dissection using binocular loupe (magnification X2.5). After lateral and caudal tractions of the thyroid gland, the upper thyroidal vessels were ligated closer to the glandular tissues in the sternothyroid–laryngeal triangle under the guidance of nerve monitoring. During and after the full mobilization of the upper pole, we attempted to visually identify the EBSLNs and examine its motor function by IONM in the triangle, as well as on the constrictor muscles. The nerve branch is generally identified parallel to the insertion line of the sternothyroid muscle onto the thyroid cartilage. The visual and also functional identification rate of the EBSLNs were determined at the end of lobe dissection.
Intraoperative Monitoring of External Branch of the Superior Laryngeal Nerve: Functional Identification, Motor Integrity, and its Role on Vocal Cord Function
Published in Journal of Investigative Surgery, 2018
The sternothyroid muscle was retracted upper and laterally. After lateral and caudal traction of the upper pole of the thyroid, a dissection window was opened between the gland and the inferior constrictor muscle. Upper thyroidal vessels were ligated closer to the glandular tissue in the sternothyroid–laryngeal triangle under guidance of nerve monitoring. During and after full mobilization of the upper pole, we tried to visually identify the EBSLN, and to check its motor function by IONM in the triangle, and also on the constrictor muscle. The nerve branch is generally identified parallel to the insertion line of the sternothyroid muscle onto the thyroid cartilage. Visual and also functional identification rate of the EBSLN was determined at the end of lobe dissection.
Evaluation Criteria and Surgical Technique for Transoral Access to the Thyroid Gland: Experimental Study
Published in Journal of Investigative Surgery, 2019
Alexander M. Shulutko, Vasiliy I. Semikov, Elkhan G. Osmanov, Sergey E. Gryaznov, Anna V. Gorbacheva, Alla R. Patalova, Gaukhar T. Mansurova, Airazat M. Kazaryan
The sternohyoid and sternothyroid muscles, that cover the operated lobe of the thyroid gland, were dislocated anterolaterally with further fixation to the wall of the operating cavity using a ligature that pierced through the skin. After dissection from the trachea the thyroid isthmus was dissected with further mobilization of the lobe. By conducting the anterior-caudal traction of the lobe (held in the forceps and introduced through the trocar in the neck), the upper lobe of the gland was separated by crosscutting the upper thyroid vessels. We separated the lateral surface by conducting the medial traction of the lobe and cross-cutting the medial plexus vein. Further procedures included cross-cutting the Berry ligament and mobilizing the lobe's lower pole.