Thyroidectomy
John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie in Basic Sciences Endocrine Surgery Rhinology, 2018
Lateral retraction of the sternohyoid muscle allows access to the sternothyroid muscle. This should again be grasped with atraumatic forceps. Medial traction on the thyroid gland allows dissection of the muscle from the surface of the gland. Attention should be paid to this plane, which is elevated close to the muscle. Evidence of extrathyroid extension at this point should alert the surgeon to the advanced local stage and will alter the approach to the gland. If extrathyroid extension into the straps is evident, the muscle should be excised by dividing above and below the gland.
Head and neck
Aida Lai in 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
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
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
Emin Gurleyik, Gunay Gurleyik
The sternothyroid muscle was retracted at the upper level and laterally during upper pole dissection using binocular loupe (magnification X2.5).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.
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
Platysma is freed from the skin layer, generally for 3 to 4 cm away from the site of the incision, in order to avoid any traction. It is then cut longitudinally, along the course of its fibers. The anterior border of the SMC is identified, with the carotid sheath coursing beneath it and containing the internal carotid artery (ICA), internal jugular vein (IJV) and vagus nerve. A pre-sternocleidomastoid precarotid exposure is carried out (Figure 1(d)). Omohyoid muscle is then isolated at a deeper level, encircled with a vessel loop and medialized (Figure 1(e)). Sternothyroid muscle, esophagus and trachea are left medially. The widening of the avascular plane between the SMC laterally and trachea and esophagus medially allows for easy identification of the pre-vertebral fascia. The fascial opening exposes the vertebral body and the medial border of the longus colli muscles. Moving laterally under microscopic vision leads to the identification of the lateral border of the ipsilateral longus colli. In a further lateral position, longus capitis and anterior scalene muscle are just lateral to the longus colli at C3-C4 and C4-C5, respectively.
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
Emin Gurleyik, Gunay Gurleyik
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.