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The Zuckerkandl's tubercle: a useful anatomical landmark for detecting both the recurrent laryngeal nerve and the superior parathyroid during thyroid surgery.

 Ji-Sup YUN  ;  Yong Sang LEE  ;  Jeong Joo JUNG  ;  Kee Hyun NAM  ;  Woong Youn CHUNG  ;  Hang Seok CHANG  ;  Cheong Soo PARK 
 ENDOCRINE JOURNAL, Vol.55(5) : 925-930, 2008 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Para-Aortic Bodies/pathology* ; Parathyroid Glands/pathology* ; Recurrent Laryngeal Nerve/pathology* ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery* ; Thyroidectomy/methods*
Zuckerkandl's tubercle ; Recurrent laryngeal nerve ; Superior parathyroid ; Anatomical landmark
Zuckerkandl's tubercle (ZT) is a well-documented anatomical structure. This study evaluated ZT anatomical characteristics in terms of the recurrent laryngeal nerve (RLN) and the superior parathyroid (SP). The study involved 325 (10 with benign tumors and 315 with malignancies) patients who underwent thyroidectomy between February and June 2007. ZTs were classified according to size: Grade 0 (unrecognizable), Grade I (10 mm). The incidence and size of the ZT and its positional relationship to the RLN and SP were investigated during thyroid surgery. ZTs were identified in most patients (right 89.3%, left 85.6%). The distribution of ZTs according to grade was as follows: Grade 0, right 10.7% and left 14.4%; Grade I, right 7.9% and left 11.1%; Grade II, right 43.5% and left 38.5%; and Grade III, right 37.9% and left 35.9%. The most common RLN course was in a groove between the ZT and the main body of the thyroid. The majority of SPs were cranial to the ZT which was located at the 1 or 2 o'clock position (96.1%) in the left, and at 10 or 11 o'clock (95.2%) in the right. The smaller the size of the ZT, the greater the distance between the ZT and the SP. There was a constant relationship between the ZT and RLN and SP. Therefore, an identification of ZT and an understanding of the relationship between the ZT and RLN and SP are essential for performing safe thyroid surgery.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
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