The role of Zuckerkandl's tubercle in revealing recurrent laryngeal nerve / 中华内分泌外科杂志

ABSTRACT

Objective To analyze the anatomical relationship between Zuckerkandl's tubercle (ZT) and the recurrent laryngeal nerve(RLN),to reduce the incidence of RLN injury risk.Methods 280 patients undergoing total thyroidectomy from Jan.2008 to Jan.2013 were included in our study.A meticulous technipue of excapsular dissection was used to dissect thyroid.ZT's size,classification,and its relationship with RLN were studied and classified.Results A total of 280 thyroid gland lobes were dissected.ZT identified in the left was 94.1％(128/136),right 96.4％(160/166),and bilateral 72.8％(220/302).ZT grades were as the following:Grade 0,left 11.8％(16/136) and right 11.4％(19/166);Grade I,left 30.1％(41/136) and right 25.3％(42/166);Grade II,left 44.1％(60/136) and right 43.4％(72/166);Grade III,left 8.1％(11/136) and right 16.3％(27/166).There was no significant difference on ZT classification between the left side and right side.For ZT with grade I or above,112 cases were at the left side,among which type A was 90.2％(101/112),type B 0.9％(1/112),type C 7.1％(8/112),and type D 1.8％(2/112),and 141 cases were at the right side,among which type A was 92.9 ％ (131/141),type B 0.7％(1/141),type C 5.0％(7/141),and type D 1.4％(2/141).There was no significant difference between the left side and the right side in terms of type.Type A of ZT was the most common type.Conclusion As an important anatomic landmark,ZT is essential for locating and dissecting RLN during thyroid surgery,however,due to its complex anatomical relationship with adjacent organs and the variability of RLN and its branches here,from which to reveal RLN has the possibility of increasing the injury risk.