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Anatomy and Physiology of Head and Neck Endocrine Glands
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The thyroid's blood supply is from paired superior and inferior thyroid arteries. The superior thyroid artery arises as the first branch of the external carotid, the inferior originates from the thyrocervical trunk. Less commonly, the isthmus receives blood from the brachiocephalic trunk via the thyroid ima artery.
Thyroid surgery
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Jessica Fazendin, Brenessa Lindeman
A surgical endocrinologist’s approach to thyroid surgery must start with a thorough understanding of the gland’s anatomy. The thyroid lies anterolateral to the trachea and is attached to it by the short, fibrous ligament of Berry. Typical thyroids are bi-lobed, their shape often likened to a butterfly, with a normal gland weighing between 15 and 20 g. As with other endocrine organs, the thyroid has a robust and intercalated system for arterial supply and venous drainage. The thyroid is supplied by two main arteries, and their subsequent branches. The superior thyroid artery, the first branch of the external carotid artery, supplies the superior poles of the gland, with the inferior thyroid artery, arising from the thyrocervical trunk, supplying the inferior poles. The inferior thyroid artery also supplies both upper and lower parathyroid glands. The venous drainage is three-fold via the superior, middle, and inferior thyroid veins, of which the first two drain into the internal jugular vein and the inferior vein drains into the brachiocephalic vein. The gland has a rich lymphatic drainage system via the Delphian (pretracheal), laryngeal, paratracheal, and lateral cervical nodes. The most common site of lymphatic drainage is to the paratracheal nodes within the central compartment of the neck (2).
Thyroid disease
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The blood supply of the thyroid is symmetric bilaterally. The superior thyroid artery is a branch of the external carotid artery, whilst the inferior thyroid artery is a branch of the thyrocervical trunk (a branch from the first part of the subclavian artery).
Ultrasound-guided thermal ablation for hyperparathyroidism: current status and prospects
Published in International Journal of Hyperthermia, 2022
Zhiguang Chen, Linggang Cheng, Wei Zhang, Wen He
The average dimensions of each gland are 5 mm × 3 mm × 1 mm (length × width × thickness), and each gland weighs approximately 60 mg [18,19]. The superior gland is relatively fixed and is located in the middle third of the posterior thyroid gland. The final position of the inferior gland changes considerably because of the relatively long descending process, with >50% located at the lower pole of the thyroid gland [20–22]. There are abundant vascular network anastomoses between the parathyroid gland and the pharynx, larynx, trachea, and esophagus. The blood supply to the parathyroid gland mainly comes from the inferior thyroid artery and, in a few cases, from the superior thyroid artery. The venous system of the parathyroid gland is accompanied by the corresponding artery, which flows into the internal jugular vein. Furthermore, the lymphatic drainage of the parathyroid gland is similar to that of the thyroid gland, leading to the deep neck and anterior trachea [23].
Intra-operative vagal neuromonitoring predicts non-recurrent laryngeal nerves: technical notes and review of the recent literature
Published in Acta Chirurgica Belgica, 2021
S. Van Slycke, K. Van Den Heede, K. Magamadov, J.-P. Gillardin, H. Vermeersch, N. Brusselaers
The intra-operative identification of the nerve is optimally performed in the same classic surgical way with attention to certain anatomical reference points such as the ligation of the medial thyroid vein. After retracting the lobe medially, a blunt and careful dissection of the superior thyroid artery of the superior lobe is designated. At that point, we individualise all arterial side branches and ligate them close to the thyroid capsule. Some mild traction on the arterial trunk of the inferior thyroid lobe can obtain us an idea of the course of the RLN. After identification of all these different structures, continuous monitoring of the vagal nerve and intermittent monitoring of the RLN or the NRLN in this particular case can prevent mindless manipulation and iatrogenic damage. In 2004, a study of 6000 thyroidectomies, described 31 cases with a NRLN course (0.5%), and iatrogenic nerve damage was reported in 12.9% of the patients with a NRLN compared to only 1.8% of the patients with a normal anatomical course [5].
Contribution of Human Trophoblast Progenitor Cells to Neurogenesis in Rat Focal Cerebral Ischemia Model
Published in Brain Injury, 2021
Kerem Yanar, Muge Molbay, Eylem Özaydın-Goksu, Gozde Unek, Emre Cetindağ, Ali Unal, Emin Turkay Korgun
After the animals were anesthetized with 4% isoflurane, a ventral midline incision was performed under a stereoscopic microscope and the surface connective tissue was dissected. After the glandular tissue was separated by blunt dissection, blunt dissection was continued until the carotid artery was found from the left side of the tracheal muscle. The two branches of the external carotid artery (ECA) were ligated with the occipital artery and the superior thyroid artery 6/0 suture and cut with a catheter. The ECA was tied as distally as possible with a 6/0 suture. The micro clamps were placed near the joints of the common carotid artery (CCA) and the internal carotid artery (ICA). Arteriotomy was performed between the two sutures at ECA. The 2.0–2.2 cm 4/0 monofilament nylon suture, a 2.0 mm long, 0.39 mm diameter silicon type, was pushed into the ECA lumen into the region where the micro clamp was toward CCA. The suture around the ECA was tightened and the location of the nylon suture was stabilized, and bleeding was prevented. The micro clamp in the ICA was then slowly removed and the nylon suture was pushed from the ECA to the ICA lumen until it reached the middle cerebral artery (MCA). After 90 minutes of occlusion, the micro clamp in CCA was removed and the skin was closed with a 3/0 suture. Under the red light, the animal was expected to wake up from anesthesia.