The effect of aging on the anatomic position of the thyroid gland

Abstract

Thyroid disease is common among elderly patients, frequently necessitating thyroid gland examination, imaging, and surgery. However, no prior studies have determined the effect of age on the anatomic position of the thyroid gland in the anterior neck. We hypothesized that the thyroid gland resides at a more caudal position in the neck in elderly patients as compared to younger patients. Head and neck CT scans were collected from 122 atraumatic patients without thyroid disease aged 18-39 years, 40-59 years, 60-79 years, and 80+ years. Measurements of thyroid gland position and other aspects of head and neck anatomy were conducted in the mid-sagittal plane. The distance between the thyroid gland and the sternal notch decreased from 45 ± 10.4 mm in the 18-39 age group to 30.8 ± 9 mm in the 80+ age group (P < 0.001). The position of the gland did not change significantly relative to anatomic landmarks in the head or neck, although the trachea was angled more closely to the horizontal plane in elderly patients (P < 0.001). Cervical spine height was also lower among patients ≥60 years of age compared to those <60 years of age (P < 0.001). Multivariate linear modeling suggested that thyroid gland position was dependent on changes in cervical spine height, hyoid bone to hard palate distance, and tracheal angle (P = 1.7 × 10 ; r = 0.37). Clinicians should be aware of the more caudad positioning of the gland when planning surgery or screening for thyroid disease in the elderly. Clin. Anat. 30:205-212, 2017. © 2016 Wiley Periodicals, Inc.

Surface anatomy of major anatomical landmarks of the neck in an adult population

“…They also reported that the distance between the thyroid gland and the sternal notch decreased with age ( P < 0.001). However, Bann et al () found no difference between age groups in thyroid position relative to the hyoid or cricoid cartilage.…”

“…However, among individuals with a thyroid mass, there was a significant gender difference in the inferior diameter of the thyroid gland [males 2.16 (±1.16) and females 3.37 (±1.30), P = 0.01, paired sample t ‐test]. Bann et al () observed that the position of the thyroid gland depends on changes in cervical spine height, hyoid to hard palate distance and tracheal angle ( P = 1.7 x 10 −11; r 2 =0.37). They also reported that the distance between the thyroid gland and the sternal notch decreased with age ( P < 0.001).…”

Case Report: A pyramidal lobe coexisting with a left-sided thyroid goiter displacing trachea and esophagus: A cadaveric finding with clinical implications

“…16 However, the type of TGo resection remains controversial. 15 Bann et al, 17 after investigating the effect of age on the distance of the TG from the sternal notch, observed that the TG was 15 mm closer to the sternal notch in patients aged 80 years and over than in patients age group-18-39 years. Thus, surgeons should direct their incision at a mean distance of 20 mm cephalad to the sternal notch.…”

MECHANISMS IN ENDOCRINOLOGY: Aging and anti-aging: a Combo-Endocrinology overview

“…Moreover, the gland is likely to reside at a more caudal position in the neck in the elderly as compared to younger individuals, which means that clinicians need to take special account of this fact when surgery is planned (77,78).…”