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Surgical Anatomy of the Thyroid
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Ashutosh Mangalgiri, Deven Mahore
Usually, the thyroid gland is drained by the superior thyroid vein, the middle thyroid vein, and the inferior thyroid vein. The superior thyroid vein and the middle thyroid vein drain into the internal jugular vein. The inferior thyroid vein drains into the brachiocephalic vein. Often, a fourth vein is seen between the middle thyroid artery and the inferior thyroid vein. If it drains into the internal jugular vein, then it is called the fourth vein of Kocher (Figure 2.11).
Neck Ultrasound
Published in John McCafferty, James M Forsyth, Point of Care Ultrasound Made Easy, 2020
The thyroid gland lies anterior to the thyroid and cricoid cartilages of the larynx and extends from the level of the fifth cervical vertebra (C5) down to the first thoracic vertebra (T1). It has two lobes, one on either side of the trachea, which are joined in the midline by the isthmus. Each lobe has a superior and inferior pole. The arterial supply comes from the superior and inferior thyroid arteries, with venous drainage via the superior, middle and inferior thyroid veins (see Figure 3.1).
Thyroid Microcirculation
Published in John H. Barker, Gary L. Anderson, Michael D. Menger, Clinically Applied Microcirculation Research, 2019
Linda J. Huffman, George A. Hedge
The venous efflux from the thyroid drains into bilateral superior, middle, or inferior thyroid veins.1,2 The superior thyroid veins lie in close proximity to the superior thyroid arteries and empty into the internal jugular vein. A middle thyroid vein may, or may not, be present, or may occur in parallel. These also empty into the internal jugular veins. The inferior thyroid veins often anastomose and form a venous plexus below the thyroid before emptying into the right or left brachiocephalic vein.
A propensity score matching study between ultrasound-guided percutaneous microwave ablation and conventional thyroidectomy for benign thyroid nodules treatment
Published in International Journal of Hyperthermia, 2018
Hao Jin, Jinrui Fan, Kun Liao, Zhuocheng He, Wei Li, Min Cui
For conventional thyroidectomy, patients received general anesthesia with endotracheal intubation. After that they were placed in a supine position with their necks slightly extended. A 4–6 cm incision was made on the superior border of the sternum. Platysma myoides were abstracted to expose the TN. From the sternal notch to the level of the thyroid cartilage, subplatysmal flap dissection was conducted. The linea alba cervicalis was vertically divided from the strap muscles to expose the thyroid gland. The thyroid goiter was dissected with an ultrasound knife (Johnson&Johnson Inc., New Brunswick, NJ, USA). In the process of the operation, recurrent laryngeal nerves, superior thyroid arteries, inferior thyroid arteries, superior thyroid veins, inferior thyroid veins and middle thyroid veins should be carefully identified or transected. According to the TN’s location, volume and adjacent structures, the TN was cut off solely or accompanied with the other part of the thyroid gland lobes. Parathyroid glands were identified and the blood supply to parathyroid glands was protected carefully during the operation. The surgical field was douched with 100 ml sterile distilled water (37 °C). The surgical wound was sutured with a traumatic needle and 5–0 absorbable sutures.
Indocyanine Green Angiography of Parathyroid Glands versus Intraoperative Parathyroid Hormone Assay as a Reliable Predictor for Post Thyroidectomy Transient Hypocalcemia
Published in Journal of Investigative Surgery, 2022
Hossam S. Abdelrahim, Ahmed F. Amer, Ramy Mikhael Nageeb
Under general anesthesia, a pre-excision PTH assay was obtained. All cases underwent standardized total thyroidectomy with low collar transverse neck incision then raising the sub-platysmal flaps. Investing deep fascia was incised vertically in the midline, and the strap muscles were split and retracted laterally. Ligation of the middle thyroid vein was done if present, followed by individual ligation of the superior pedicle. Care was taken to identify and preserve the superior PTG at this stage. Then ligation of inferior thyroid veins was done at the inferior pole.