O tubérculo de Zuckerkandl pode auxiliar na localização do nervo laríngeo inferior durante tireoidectomias?

Freitas, Carlos Alberto Ferreira de; Paroni, Amauri Ferrari; Santos, Andreza Negreli; Silva, Rônei Jorge Santos da; Souza, Rafael Oliveira de; Silva, Tatyanne Ferreira da; Levenhagen, Maria Margarida Morena Domingos

doi:10.1590/0100-6991e-20192249

Cited by 5 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ZT is present in most individuals who have been studied and has a constant relationship with the RLN close to its entry into the larynx. The RLN is typically located between the ZT and the trachea, posterior to the tubercle, which is an anatomical reference that can be used to help localize the nerve at this point [ 3 ]. The NRLN is typically associated with vascular malformation, although it has been found in isolation [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relation of Nonrecurrent Laryngeal Nerve with Zuckerkandl’s Tubercle

Freitas

Levenhagen

Constantino

et al. 2020

Case Reports in Surgery

Self Cite

View full text Add to dashboard Cite

The nonrecurrent laryngeal nerve (NRLN) is a rare anatomical variation of the recurrent laryngeal nerve (RLN) that may hinder the identification and preservation of this nerve during surgery and is associated with increased iatrogenic risks. Zuckerkandl’s tubercle (ZT) is considered a useful reference for locating the RLN during thyroid surgery. We report the case of an asymptomatic patient with a 23 mm uninodular goitre suspicious for cancer. Ultrasound examination showed a hypoechoic nodule with regular contours and microcalcifications. The patient had normal thyroid-stimulating hormone and thyroxine levels, and aspiration biopsy was suspicious for follicular cancer. She was treated with total thyroidectomy after the intraoperative examination confirmed the presence of a papillary thyroid carcinoma. The standard approach to the RLN below the inferior thyroid artery was used on both sides. The nerve displayed anatomical variation in the nonrecurrent form (NRLN) on the right side and was associated with another variation that was not found in the consulted literature. It was completely surrounded by thyroid tissue in the region of ZT, and the surgeon was forced to remove it from within the thyroid tissue. This combination of anatomical variations seems to be quite rare. Knowledge of the anatomy of the RLN and its variations, as well as its identification and careful dissection, is essential to avoid injury to the nerve during surgical procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Zuckerkandl's tubercle (ZT) is a lateral projection of the thyroid gland that is present in most people (68%), and when present, it is a useful landmark for the identification of the RLN during thyroid and parathyroid surgery [ 3 ]. The RLN is located posterior to the ZT, near the site at which the RLN enters the larynx [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Relation of Nonrecurrent Laryngeal Nerve with Zuckerkandl’s Tubercle

Freitas

Levenhagen

Constantino

et al. 2020

Case Reports in Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Protect the recurrent laryngeal nerves in US-guided microwave ablation of thyroid nodules at Zuckerkandl tubercle: a pilot study

Hu,

Wang,

et al. 2024

BMC Cancer

View full text Add to dashboard Cite

Background To evaluate the safety and efficacy of US-guided microwave ablation in patients with thyroid nodules at Zuckerkandl tubercle. Methods 103 consecutive patients with thyroid nodules at Zuckerkandl tubercle (ZTTN) were enrolled in this study from November 2017 to August 2021. Prior to the surgery or US-guided microwave ablation (MWA), preoperative ultrasound visualization of the recurrent laryngeal nerve (RLN) and ZTTN was performed, the size and the position relationship between them were observed. Patients were followed up at 1, 3, 6, and 12 months after MWA and the volume reduction rates (VRR) of the thyroid nodules were analyzed. Results All patients successfully had the RLN and ZTTN detected using ultrasound before surgery or ablation with a detection rate of 100%. For the 103 patients, the majority of ZTTN grades were categorized as grade 2, with the distance from the farthest outside of ZTTN to the outer edge of thyroid ranging between 6.0 and 10.0 mm. The position relationship between ZTTN and RLN was predominantly type A in 98 cases, with type D observed in 5 cases. After MWA, the median nodule volume had significantly decreased from 4.61 (2.34, 8.70) ml to 0.42 (0.15, 1.41) ml and the VRR achieved 84.36 ± 13.87% at 12 months. No nodules regrew throughout the 12-month follow-up period. Of the 11 patients experienced hoarseness due to RLN entrapment before ablation, 7 recovered immediately after separation of the RLN and ZTTN during MWA, 2 recovered after one week, and the other 2 recovered after two months. Conclusions The RLN is closely related to ZTTN and mainly located at the back of ZTTN. The RLN can be separated from ZTTN by hydrodissection during MWA. US-guided MWA is a safe and effective treatment for ZTTN.

show abstract

Protect the Recurrent Laryngeal Nerves in US-guided Microwave Ablation of Thyroid Nodules at Zuckerkandl tubercle: A Pilot Study

Hu,

Wang,

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: To evaluate the safety and efficacy of US-guided microwave ablation in patients with thyroid nodules at Zuckerkandl tubercle. Methods: 113 consecutive patients with thyroid nodules at Zuckerkandl tubercle (ZTTN) were enrolled in this study from November 2017 to August 2021. Prior to the surgery or US-guided microwave ablation (MWA), preoperative ultrasound visualization of the recurrent laryngeal nerve (RLN) and ZTTN was performed, the size and the position relationship between them were observed. Patients were followed up at 1, 3, 6, and 12 months after MWA and the volume reduction rates (VRR) of the thyroid nodules were analyzed. Results: All patients successfully had the RLN and ZTTN detected using ultrasound before surgery or ablation with a detection rate of 100%. For the 103 patients, the majority of ZTTN grades were categorized as grade 2, with the distance from the farthest outside of ZTTN to the outer edge of thyroid ranging between 6.0 and 10.0 mm. The position relationship between ZTTN and RLN was predominantly type A in 100 cases, with type D observed in 3 cases. After MWA, the median nodule volume had significantly decreased from 4.61 (2.34, 8.70) ml to 0.42 (0.15, 1.41) ml and the VRR achieved 84.36±13.87% at 12 months. No nodules regrew throughout the 12-month follow-up period. Of the 11 patients experienced hoarseness due to RLN entrapment before ablation, 7 recovered immediately after separation of the RLN and ZTTN during MWA, 2 recovered after one week, and the other 2 recovered after two months. Conclusions: The RLN is closely related to ZTTN and mainly located at the back of ZTTN. The RLN can be separated from ZTTN by hydrodissection during MWA.US-guided MWA is a safe and effective treatment for ZTTN.

show abstract

O tubérculo de Zuckerkandl pode auxiliar na localização do nervo laríngeo inferior durante tireoidectomias?

Cited by 5 publications

References 15 publications

Relation of Nonrecurrent Laryngeal Nerve with Zuckerkandl’s Tubercle

Relation of Nonrecurrent Laryngeal Nerve with Zuckerkandl’s Tubercle

Protect the recurrent laryngeal nerves in US-guided microwave ablation of thyroid nodules at Zuckerkandl tubercle: a pilot study

Protect the Recurrent Laryngeal Nerves in US-guided Microwave Ablation of Thyroid Nodules at Zuckerkandl tubercle: A Pilot Study

Contact Info

Product

Resources

About