Landmark for Identification and Location of Parathyroid Glands during Thyroidsurgeries

Parathyroid glands always remain at risk of damage during the thyroid surgery as they lie in close proximity to the thyroid gland. Parathyroid glands are small endocrine glands that produce parathyroid hormone. The major function of parathyroid hormone is to maintain the level of calcium and phosphate within a narrow range in the body. Aim of the present study was to locate and identify the parathyroid glands during thyroid surgery and to observe their relationship with the surgical landmarks. The present study was a prospective study conducted in the department of otorhinolaryngology and HNS in SMGSH, GMC, Jammu for a time period of 1 year from Nov.2015 to Oct. 2016. 40 patients undergoing thyroid surgery were included in the study. Meticulous technique was employed during dissection and parathyroid glands were identified in the surgical field. Location of the each parathyroid gland was determined in relation to a nearby surgical landmark. The study included 12 right (R) and 8 left (L) hemithyroidectomies, 10 sub- total thyroidectomies and 1 total thyroidectomy. An average of 1.2 parathyroid glands were identified in hemithyroidectomies and 2.4 was the average number of parathyroid glands identified in subtotal and total thyroidectomies. Location of parathyroid glands was observed in relation to cricothyroid (CT) joint, recurrent laryngeal nerve (RLN), inferior thyroid artery (ITA) and tubercle of Zukerkandl for superior parathyroid glands, and in relation to RLN, RLN & ITA junction, tubercle of Zukerdandl & lower pole for inferior parathyroid glands. In this study RLN was the most frequent landmark for identification of superior parathyroid gland while the inferior parathyroid glands were frequently seen related to the lower pole of the thyroid gland.

Morphometeric Analysis of Mental Foramen in Human Mandibles of South Gujarat.

Mental Foramen is found on the anterolateral aspect of the mandible and transmits mental nerves and vessels. The knowledge of anatomical morphometry of mental foramen is essential in clinical dentistry when administering regional anesthesia and performing periapical surgery in the mental region of the mandible. Mental nerve leaving the foramen is anesthetized during the dental procedures, suturing of soft tissue lacerations of mouth and biopsy. The aim of the study was to elucidate the morphological features and precise anatomical position of the mental foramen with reference to surrounding anatomical landmarks in an adult South Gujarat population, the area where this information is scanty. This study was conducted using 100 dried human mandibles of unknown sex obtained from the Department of Anatomy, S.M. Institute of Medical Education & Research and Government Medical College, Surat. The parameters including size, shape, number, location and dimensions of mental foramen with respect to the surgically encountered anatomical landmarks were studied. In most of the cases the foramen was oval in shape and situated in the line with the longitudinal axis of the 2nd premolar tooth. Its usual opening was in a postero-superior direction.

Surgical Anatomical Landmarks for Petrous Apex / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anatomical knowledge of the petrous apex is essential to otolaryngologist to explore the skull base lesions. This study was designed to investigate the surgical anatomy of the petrous apex and the middle cranial fossa. MATERIALS AND METHODS: We dissected 32 temporal bones in order to establish the anatomical relationships of petrous apex structures. We measured distances and angles between different structures so that surgeons can rely on to work in this area. RESULTS: The results of the present study showed distances and angles of the different petrous apex structures. The angle between posterior point-foramen spinosum and porus was 90 degree. CONCLUSION: We could suggest the new indicators to identify the internal acoustic canal.

Surgical Anatomy for the Extended Middle Fossa Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The extended middle fossa approach is an essential method in approaching the internal acoustic canal and the cerebellopontine angle while preserving the hearing function. This work attempted to establish some anatomical landmarks in the petrous apex as it relates to the extended middle fossa approach. MATERIALS AND METHODS: We dissected 49 human skulls of Korean origin by using the extended middle fossa approach. RESULTS: Internal acoustic canal (IAC) was identified in an attempt to find reliable distances and angles to be used in the extended middle fossa approach. In addition, the dimensions of the fundus of IAC and IAC as well as the extension ranges were obtained. CONCLUSION: The extended middle fossa approach is a good method in approaching the internal acoustic canal and cerebellopontine angle. In this study, we have established anatomical landmarks for using this approach in the human skulls of Korean origin.