Pyramidal Artery: An Artery to Pyramidal Lobe—A New Nomenclature

Abstract

Thyroid lobes are supplied by superior and inferior thyroid arteries. We dissected out a specific arterial pattern always present along with a well developed pyramidal lobe. Authors named this as "Pyramidal Artery". This may be a common unnoticed bleeding site during surgery. Thyroid anomalies are commonly observed as incidental finding during surgery. Presence of pyramidal lobe is the most common finding among other thyroid anomalies due to persistence of thyroglossal duct. Present study reported incidence of pyramidal lobe in 41.46% cases and pyramidal lobe branches off more frequently from left lobe than right. Special attention has to be paid during total thyroidectomy in order not to leave the thyroid tissue. Few such anatomical variations and surgical importance of vascular pattern in such cases is discussed in paper.

The prevalence and anatomy of the pyramidal lobe of the thyroid gland: A meta‐analysis with implications for thyroid surgery

“…Thousand five hundred and forty‐three articles were screened, and 156 were subjected to a full‐text evaluation. Finally, 24 studies reached the criteria and were included in the present meta‐analysis (Akudu et al, 2018; Al‐Azzawi & Takahashi, 2021; Ayandipo et al, 2018; Braun et al, 2007; Cengiz et al, 2013; Dessie, 2018; Freilinger et al, 2022; Gurleyik et al, 2015; Harjeet et al, 2004; Irawati et al, 2016; Kim et al, 2013, 2014, 2015; Kim, Ha, et al, 2014; Léger et al, 2002; Mangalgiri et al, 2018; Mortensen et al, 2014; Ozgur et al, 2011; Park et al, 2012; Prakash et al, 2012; Ryu et al, 2014; Savage et al, 1984; Sawicka‐Gutaj et al, 2014; Siraj et al, 1989). To minimize potential bias and maintain an accurate statistical methodology, articles such as case reports, case series, conference reports, reviews, letters to the editor, and studies that provided incomplete or irrelevant data were excluded.…”

A plea for extension of the anatomical nomenclature: Vessels

“…In the two latter cases, it could compress the esophagus and may cause problems with swallowing termed dysphagia lusoria that is why in the case of present clinical symptoms, the variant artery used to be called the “arteria lusoria” [ 11 , 31 ]. Arteria pyramidalis is a variant branch from the distal part of the arteria thyroidea superior , just before its bifurcation into its ramus anterior et posterior , supplying the lobus pyramidalis glandulae thyroideae , when present (40% of cases) [ 32 ]. Arteria supraclavicularis is a smaller branch either from the arteria transversa cervicis directly [ 10 ] or from its ramus superficialis , coursing within the regio cervicalis lateralis and supplying the fascia and the skin above and below the clavicle.…”

“…Arteria pyramidalis is a variant branch from the distal part of the arteria thyroidea superior , just before its bifurcation into its ramus anterior et posterior , supplying the lobus pyramidalis glandulae thyroideae , when present (40% of cases) [ 32 ].…”