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

2014 ◽  
Vol 128 (4) ◽  
pp. 368-371
Author(s):  
Michael Persky ◽  
Y Fang ◽  
D Myssiorek
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Parathyroid Gland ◽  
Laryngeal Nerve ◽  
The Other ◽  
Thyroid Lobe ◽  
Close Proximity ◽  
Anatomical Relationship ◽  
Nerve Paresis ◽  
Relationship Of ◽  
The Relationship

AbstractDesign: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.

scholarly journals Incidence of tubercle of Zuckerkandl of the thyroid and it’s surgical relation with recurrent laryngeal nerve and the superior parathyroid gland

2021 ◽  
Vol 9 (1) ◽  
pp. 137
Author(s):  
Lemin Mohan Puravankara ◽  
Ellikunnel Vithon Gopi
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Parathyroid Gland ◽  
Anatomical Landmark ◽  
Laryngeal Nerve ◽  
Government Medical College ◽  
Medical College ◽  
Posterior Extension ◽  
The Right ◽  
Relationship Of ◽  
The Relationship

Background: This study was carried out with the objective to identify the tubercle of Zuckerkandl in patients undergoing thyroidectomy and to establish the relationship of TZN with the recurrent laryngeal nerve and superior parathyroid gland.Methods: 100 patients posted for thyroidectomy for various causes in Government medical college, Kozhikode for a period of 1 year between March 2014 and March 2015. 92 patients underwent total thyroidectomy, 4 patients underwent left hemithyroidectomy and 4 patients underwent right hemithyroidectomy. A total of 192 lobes i.e. 96 right lobes and 96 left lobes were studied.Results: Of the 100 patients studied TZN was identified in 63 (63%) patients. Of the 192 lobes studied, TZN was identified in 100 lobes (52.08%). This was 59 of 96 (61.40%) lobes on the right side and 41 of 96 (42.70%) lobes on the left side. Of the 92 Total Thyroidectomies, TZN was found bilaterally in 36 (39.10%) cases. RLN was identified ‘posteromedial’ in relation in 99 of the 100 (99%) TZNs studied and not visualized in relation to TZN in 1 (1%) case. The Superior Parathyroid was identified ‘superolateral’ in relation in 93 (93%), ‘lateral’ in 6 (6%) and ‘inferolateral’ in 1 (1%) of 100 TZNs studied.Conclusions: Zuckerkandl’s tubercle is a posterior extension of lateral lobes of the thyroid gland, maintains a constant relationship with the RLN and the superior parathyroid gland. It can be used as an anatomical landmark to assist in preservation of the RLN and the superior parathyroid gland during thyroid surgery.

scholarly journals Identifying Recurrent Laryngeal Nerve in Thyroid Surgery Using Relationship with Superior Parathyroid Gland and Tubercle of Zuckerkandl

2015 ◽  
Vol 23 (3) ◽  
pp. 99-103
Author(s):  
Somesh Mozumder ◽  
Shirish Dubey ◽  
Aniruddha Dam ◽  
Anup Kumar Bhowmick
Keyword(s):  
Prospective Study ◽  
Recurrent Laryngeal Nerve ◽  
Parathyroid Gland ◽  
Thyroid Surgery ◽  
Intimate Relationship ◽  
Laryngeal Nerve ◽  
Laryngeal Nerves ◽  
Recurrent Laryngeal Nerves ◽  
A Prospective Study ◽  
Relationship Of

Introduction: Recurrent laryngeal nerves (RLN) are particularly prone to injury during thyroid surgeries due to its intimate relationship and proximity with the gland. Zuckerkandl’s tubercle (ZT) helps in preserving RLN intra operative. Material and Methods: A prospective study for identifying RLN in thyroid surgery using relationship with superior parathyroid gland and tubercle of Zuckerkandl was conducted on 50 thyroidectomy patients between August 2013 and February 2014. Results: In all cases ZT was identified. Temporary paralysis of RLN was seen in 3 (6%) cases and permanent paralysis in 2 (4%) of cases. Discussion: The site of greatest risk during thyroidectomy to the RLN is in the last 2-3 cm extralaryngeal course of the nerve. Relationship of recurrent laryngeal nerve with superior parathyroid gland and tubercle of Zukerkandl (ZT) is known. Conclusion: Use of ZT and superior parathyroids as a landmark allows safe dissection of RLN.

scholarly journals Relationship between the recurrent laryngeal nerve and the inferior thyroid artery: a study in corpses

2000 ◽  
Vol 55 (6) ◽  
pp. 195-200 ◽  
Author(s):  
Bernardo Almeida Campos ◽  
Paulo Roberto Ferreira Henriques
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Significant Difference ◽  
Racial Variations ◽  
Anatomical Relationship ◽  
The Right ◽  
The Relationship

The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) was studied in 76 embalmed corpses, 8 females and 68 males. In both sexes, the RLN lay more frequently between branches of the ITA.; it was found in this position in 47.3% of male corpses and 42.8% of female ones. On the right, RLN was found between branches of the ITA in 49.3% of the cases, anterior to it in 38.04%, and posterior in 11.26%. On the left, the RLN lay between branches of the ITA in 44.45%, posterior to the ITA in 37.05%, and anterior to it in 18.05% of the cases. In 62.68% of the cases, the relationship found on one side did not occur again on the opposite side. There was a significant difference (p<0.05) in the distribution of the 3 types of relationships between the RLN and the ITA, on the right and on the left. Racial variations could contribute to an explanation of the differences observed by authors of different countries in the relationship between the RLN and the ITA.

scholarly journals Clinical impacts of the Sudanese anatomical variations in a relation of the recurrent laryngeal nerve to the inferior thyroid artery

2020 ◽  
Vol 8 (2) ◽  
pp. 25
Author(s):  
Mohamed Elghazali Elhasan ◽  
Wael Mohialddin Doush
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Parathyroid Glands ◽  
Main Trunk ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background: Until recently, the knowledge of the anatomical variations in the relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) combined with visual intraoperative RLN identification are essential for the protection of these life-important structures during surgical exposure and the mobilization of thyroid and parathyroid glands. This leads to the proper treatment of patients and improvement of the surgical techniques.Aim: To describe anatomical variations in the relationship of the recurrent laryngeal nerve to the inferior thyroid artery in the Sudanese population.Patients and methods: Following ethical committee approval, an observational descriptive prospective cross-sectional study in the period between March 2019 and February 2020, for anatomical variations in the relation of the recurrent laryngeal nerve to the inferior thyroid artery in seventy-two cervical sides of thirty-six well-dissected embalmed Sudanese cadavers. The RLN was investigated in three positions: posterior to the ITA main trunk, anterior to the ITA main trunk and between the ITA branches. Then, the results were analyzed according to the gender, age and dissection side.Results: We found that the anatomical variations were more frequent in males (97.2%) than females (2.8%). The age of these variations ranged between 31–45 years which represents (61.1%). On the right side of the neck, the commonest position of the RLN is posterior to the ITA (63.9%) followed by in decreasing order of frequency, the RLNs run between the ITA branches (30.6%) and anterior to the ITA (5.6%). On the left side of the neck, the commonest position of the RLN is posterior to the ITA (69.4%). It passed between the ITA branches in (30.6%) of specimens. There was no anterior location of the RLN to the ITA. Variations in a relationship of the RLN to the ITA on one side is significantly different from the opposite side.Conclusions: Although the risk of potential damage to the RLN during surgical neck procedures involving the thyroid gland and parathyroid glands is well recognized, pre-operative detailed surgeon’s knowledge for these frequent anatomical variations and the usage of the ITA as an anatomical landmark for intraoperative RLN recognition is important. This will lead to a reduction of iatrogenic RLN injury prevalence. Future studies are recommended to compare the findings on this cadaveric study with a larger sample size in the long-term period.  

scholarly journals On Newcomb's method of investigating periodicities and its application to Brückner's weather cycle

1914 ◽  
Vol 90 (619) ◽  
pp. 349-355
Keyword(s):  
Thermal Radiation ◽  
The Other ◽  
New Method ◽  
Critical Examination ◽  
Numerical Work ◽  
Average Value ◽  
Other Hand ◽  
Relationship Of ◽  
The Relationship ◽  
Great Simplicity

During the last few years of his life Prof. Simon Newcomb was keenly interested in the problem of periodicities, and devised a new method for their investigation. This method is explained, and to some extent applied, in a paper entitled "A Search for Fluctuations in the Sun's Thermal Radiation through their Influence on Terrestrial Temperature." The importance of the question justifies a critical examination of the relationship of the older methods to that of Newcomb, and though I do not agree with his contention that his process gives us more than can be obtained from Fourier's analysis, it has the advantage of great simplicity in its numerical work, and should prove useful in a certain, though I am afraid, very limited field. Let f ( t ) represent a function of a variable which we may take to be the time, and let the average value of the function be zero. Newcomb examines the sum of the series f ( t 1 ) f ( t 1 + τ) + f ( t 2 ) f ( t 2 + τ) + f ( t 3 ) f ( t 3 + τ) + ..., where t 1 , t 2 , etc., are definite values of the variable which are taken to lie at equal distances from each other. If the function be periodic so as to repeat itself after an interval τ, the products are all squares and each term is positive. If, on the other hand, the periodic time be 2τ, each product will be negative and the sum itself therefore negative. It is easy to see that if τ be varied continuously the sum of the series passes through maxima and minima, and the maxima will indicated the periodic time, or any of its multiples.

scholarly journals Physical Activity and Psychological Well-Being: Testing Alternative Sociological Interpretations

1990 ◽  
Vol 7 (4) ◽  
pp. 329-346 ◽  
Author(s):  
William McTeer ◽  
James E. Curtis
Keyword(s):  
Physical Activity ◽  
Socioeconomic Status ◽  
Social Interaction ◽  
Physical Fitness ◽  
Well Being ◽  
The Other ◽  
Positive Zero ◽  
Psychological Well Being ◽  
Relationship Of ◽  
The Relationship

This study examines the relationship between physical activity in sport and feelings of well-being, testing alternative interpretations of the relationship between these two variables. It was expected that there would be positive relationships between physical activity on the one hand and physical fitness, feelings of well-being, social interaction in the sport and exercise environment, and socioeconomic status on the other hand. It was also expected that physical fitness, social interaction, and socioeconomic status would be positively related to psychological well-being. Further, it was expected that any positive zero-order relationship of physical activity and well-being would be at least in part a result of the conjoint effects of the other variables. The analyses were conducted separately for the male and female subsamples of a large survey study of Canadian adults. The results, after controls, show a modest positive relationship of physical activity and well-being for males but no such relationship for females. The predicted independent effects of the control factors obtained for both males and females. Interpretations of the results are discussed.

THE RELATIONSHIP OF THE SODIUM, POTASSIUM, AND CHLORIDE CONCENTRATION OF THE FEEDING TO THE WEIGHT GAIN OF PREMATURE INFANTS

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 909-916
Author(s):  
Herbert I. Goldman ◽  
Samuel Karelitz ◽  
Hedda Acs ◽  
Eli Seifter
Keyword(s):  
Weight Gain ◽  
Sodium Chloride ◽  
Human Milk ◽  
Premature Infants ◽  
Chloride Concentration ◽  
The Other ◽  
Milk Formula ◽  
Sodium Potassium ◽  
Relationship Of ◽  
The Relationship

One hundred four healthy premature infants, of birth weight 1,000 to 1,800 gm, were fed one of five feedings: (1) human milk; (2) human milk plus 13 meq/l of sodium chloride; (3) human milk plus 13 meq/l of sodium chloride and 18 meq/l of potassium chloride; (4) a half-skimmed cows milk formula; and (5) a partially-skimmed vegetable oil, cows milk formula. The infants fed any of the three human milk formulas gained weight at a slower rate than the infants fed either of the two cows milk formulas. Infants whose diets were changed from unmodified human milk to the half-skimmed cows milk gained large amounts of weight, and at times were visibly edematous. Infants whose diets were changed from the human milks with added sodium chloride, to the half-skimmed cows milk, gained lesser amounts of weight and did not become edematous. The infants fed the two cows milk diets gained similar amounts of weight, although one diet provided 6.5 gm/kg/day, the other 3.1 gm/kg/day of protein.

Een beetje onsterfelijk

Lampas ◽  
2019 ◽  
Vol 52 (4) ◽  
pp. 437-452
Author(s):  
Gerard Boter
Keyword(s):  
Present Article ◽  
The Other ◽  
Relationship Of ◽  
The Relationship ◽  
Immortality Of The Soul

Summary The present article discusses three hotly debated interpretational issues in Diotima´s speech in Plato´s Symposium. The first of these is the relationship of Diotima´s speech to other dialogues, such as the Phaedo and the Republic, with regard to the immortality of the soul. It is argued that there is no discrepancy at all, because the immortality of the soul does not play any role in the Symposium. The second issue is the nature of the three classes of posterity: biological, spiritual and philosophical. Whereas the posterity of the first two classes can be relatively easily defined, the character of the philosopher´s posterity, ‘true virtue’, remains rather vague. It may consist in dialectical teaching of the Idea of Beauty by Socrates. Thirdly, it is argued that the philosopher´s immortality differs only gradually from the immortality of the other two classes, that is, the philosopher as a man only survives by means of his posterity.

Comparing the Arrangements of Governance and Sustainable Development in OECD Countries: Coupled or Decoupled?

2019 ◽  
Vol 34 (1) ◽  
pp. 99-117
Author(s):  
Huh Taewook
Keyword(s):  
Sustainable Development ◽  
Oecd Countries ◽  
The Other ◽  
Type Analysis ◽  
Ideal Types ◽  
Type 3 ◽  
Relationship Of ◽  
The Relationship

This study attempts to analyze to what extent governance and sustainable development (SD) empirically appear compatible in the thirtyfive OECD countries through the fuzzy-set ideal type analysis, and identify which ideal types appear coupled or decoupled, and then reveal which countries belong to the coupled types or to the decoupled types. In short, twenty-two countries (including Sweden (fuzzy score, 0.953), Denmark (0.920), Finland (0.914), Norway (0.911) in Type 1 (G*S, ‘strong G-S coupled countries’); and Turkey (0.906), Greece (0.833), Mexico (0.828) in Type 4 (g*s, ‘lite g-s coupled countries’) are in line with the accepted conventions regarding the compatible relationship between governance and SD. On the other hand, the rest of thirteen countries (including USA (fuzzy score, 0.815), Luxembourg (0.721), Australia (0.660) in Type 2 (G*s, ‘G-s decoupled countries’); and Slovenia (0.728), France (0.644), Czech Rep. (0.625) in Type 3 (g*S, ‘g-S decoupled countries’) may indicate that the relationship of governance and SD is in fact experiencing tensions in the national contexts. These findings are characterized by the substance (of SD) and procedure (of governance) divide. Considering the results, this study focuses on the idea of reflexivity or reflexive capacity.

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