Thyroid Gland- Surgical Anatomy
March 2019 VARSHNEY UG Lecture 1 Bi-lobed gland over 2nd & 3rd tracheal ring
Weight : 20 – 30 gr
March 2019 VARSHNEY UG Lecture 2 Samuel D. Gross – 1866 , Philadelphia
A System of Surgery
Thyroid surgery: ‘Horrid butchery’
“No honest and sensible surgeon would ever engage in thyroid surgery”
March 2019 VARSHNEY UG Lecture 3 1909 Nobel Prize
Theodur Kocher (1841-1917)
• Mortality: • 1889 – 2.4% • 1900 – 0.18% • Emphasis on meticulous technique • Performed 5000 cases by death in 1917
March 2019 VARSHNEY UG Lecture 4 Thyroidectomy
Neck Release Moraitis, Shaha. JSO 2006
•Open the “gift wrap” •Separate fascia from the muscles •Separate strap muscles •Separate sternomastoid muscle
March 2019 VARSHNEY UG Lecture 5 Thyroid Gland moves with deglutition
Ligament of Berry (Condensation of Pretracheal fascia)
Inferior constrictor- 2 parts Thyropharyngeus {Thyroid cartilage} Cricopharyngeus {Cricoid cartilage} [Contraction – Thyroid and cricoid move up]
March 2019 VARSHNEY UG Lecture 6 The thyroid gland is a very vascular structure.
Superior thyroid artery (ECA),
Inferior thyroid artery ( Thyrocervical trunk)
Arteria thyroideaima artery (2-12% ) (innominate, subclavian, right common carotid, internal mammary, or the aortic arch.
March 2019 VARSHNEY UG Lecture 7 The superior thyroid vein follows the pathway of the superior thyroid artery.
The middle thyroid veins directly flow into the internal jugular vein.
The inferior thyroid veins can be found just anterior to the trachea and often anastomose with each other
March 2019 VARSHNEY UG Lecture 8 Nerve supply
March 2019 VARSHNEY UG Lecture 9 SLN
Dissection of the superior thyroid vessels parallel to the vessels on surface of thyroid & exposure of SLN.
March 2019 VARSHNEY UG Lecture 10 Laryngeal Nerves
March 2019 VARSHNEY UG Lecture 11 Beahr`s Triangle
March 2019 VARSHNEY UG Lecture 12 March 2019 VARSHNEY UG Lecture 13 Goitre
March 2019 VARSHNEY UG Lecture 14 March 2019 VARSHNEY UG Lecture 15 March 2019 VARSHNEY UG Lecture 16 THYROIDECTOMY
March 2019 VARSHNEY UG Lecture 17 Skin Incision
March 2019 VARSHNEY UG Lecture 18 Superficial Dissection
Platysma
Anterior Jugular Veins Jugular Venous Arch
March 2019 VARSHNEY UG Lecture 19 Exposure of Strap Muscles
• Investing Layer of Deep Cervical Fascia •Sternothyroid • Sternohyoid Muscle •Superior belly of Omohyoid March 2019 VARSHNEY UG Lecture 20 Separating the Strap Muscles and Exposing the Anterior Surface of the Thyroid
March 2019 VARSHNEY UG Lecture 21 March 2019 VARSHNEY UG Lecture 22 March 2019 VARSHNEY UG Lecture 23 March 2019 VARSHNEY UG Lecture 24 QUESTIONS ???
March 2019 VARSHNEY UG Lecture 25