This is how I do it. Exposure of the superior thyroid pedicle during thyroidectomy
โ Scribed by Ashok R. Shaha
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 103 KB
- Volume
- 52
- Category
- Article
- ISSN
- 0022-4790
No coin nor oath required. For personal study only.
โฆ Synopsis
Exposure of the superior pedicle is an important step during the performance of thyroid surgery to avoid injury to the superior laryngeal nerve, and to minimize troublesome bleeding from multiple branches of the superior thyroid vessels. Occasionally, exposure of this region can be difficult, especially if the superior thyroid pole is high above the cricothyroid membrane or if there is considerable enlargement of the thyroid in this region. Dividing and retracting the strap muscles is one of the common techniques utilized. However, we have noted that it is not necessary to cut both the strap muscles, sternohyoid and sternothyroid in every case. The technique I have utilized is dividing the investing layer of fascia, covering the sternohyoid and sterncleidomastoid muscles so that both these muscles can be retracted laterally, thereby exposing the sternothyroid muscle (Fig. 1).At this time, if the superior thyroid pedicle is difficult to expose, I transect the sternothyroid muscle instead of cutting both the strap muscles (Fig. 2).The resultant exposure has helped to assure safe ligation of the superior thyroid vessels (Fig. 3).
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