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Relationship of the recurrent laryngeal nerve to the superior parathyroid gland during thyroidectomy

Published online by Cambridge University Press:  25 March 2014

Michael Persky ,
Y Fang  and
D Myssiorek
Michael Persky
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, USA
Y Fang
Affiliation:
Division of Biostatistics, Department of Population Health, New York University School of Medicine, USA
D Myssiorek*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, USA
*
Address for correspondence: Dr D Myssiorek, NYU Clinical Cancer Center, 160 E34th Street, New York, NY 10016, USA Fax: 001 212 731 5502 E-mail: David.Myssiorek@nyumc.org
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Abstract

Design:

The relationship of the recurrent laryngeal nerve to the superior parathyroid gland during consecutive thyroidectomies was prospectively evaluated. When one structure was noted, careful dissection was performed to locate the other structure, to preserve their natural anatomical relationship.

Patients:

In total, 103 consecutive thyroid lobectomies were performed on 73 patients. The distance from the superior parathyroid gland to the recurrent laryngeal nerve was recorded.

Results:

In 88 cases (88.9 per cent), the superior parathyroid gland was identified within 5 mm of the recurrent laryngeal nerve. In 62 cases (62.6 per cent), the gland was within 1 mm of the recurrent laryngeal nerve. The height of the thyroid lobe was positively associated with the distance between the two structures (p = 0.001), as was the incidence of cancer (p = 0.033). The incidence of recurrent laryngeal nerve paresis was less than 4 per cent.

Conclusion:

In most cases, the recurrent laryngeal nerve was found in close proximity to the superior parathyroid gland. In a thyroid gland with a large height, or in a cancerous lobe, this relationship is less reliable.

Keywords

Recurrent Laryngeal NerveDiagnosisAnatomyParathyroid GlandThyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 4 , April 2014 , pp. 368 - 371
Copyright
Copyright © JLO (1984) Limited 2014 

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