Proposal for anatomical classification of the superior pole in thyroid surgery

Abstract

Objective To propose a distinct anatomical classification for the superior thyroid pole that may serve as a surgical landmark and could help reduce complications in thyroid surgery. Materials and Methods A comprehensive anatomical study based on existing literature and surgical observations. Results The proposed superior pole classification is based on two parameters that closely interact: one is the shape of the superior pole and the other is the structure of the vascular pedicle of the superior pole. We have come up with three distinct types of superior thyroid pole anatomical structure that may be predictive of the risk for both hemorrhage and nerve injury. Conclusions Superior pole classification may serve as a guiding tool during thyroid surgery in order to reduce complications such as bleeding and injury to the external branch of the superior laryngeal nerve.

The prevalence of thyroid ima artery and its clinical significance

“…22 The presence of a TIA can complicate such surgeries as physicians may fail to recognize it due to its unpredictable location, morphology, and relative rarity, as well as variations in nomenclature. 4,23 With a large prevalence range of 1-15% reported in the general population, the percentage measured in this study was within this average. Advances in hemostatic surgical techniques and agents, however, have decreased the mortality and morbidity associated with operative hemorrhage and postoperative hematomas, thus mitigating such concerns.…”

Anatomía Topográfica del Nervio Laríngeo Superior: Importancia Quirúrgica en las Tiroidectomías

“…Menon et al (2017) encontraron que bocios mayores a 50 cc presentaron mayor número de entrecruzamientos vasculonerviosos a una distancia menor al cm del PSGT (Ha et al, 2015;Menon et al). Mizrachi et al (2015), en 35 años de actividad quirúrgica en uno de los mayores centros quirúrgicos a nivel mundial, presentan una propuesta de clasificación anatómica del PSGT que tiene implicancia en la relación de la glándula tiroides con el RLNLS, la ATS y el entrecruzamiento entre ambos. El tipo 1 propuesto es aquel en que el PSGT tiene una forma piramidal y en el que los elementos del pedículo superior se encuentran próximos entre si.…”