Клиническая анатомия околощитовидных желез, новые данные и подходы

Abstract

New approaches to the assessment of clinical anatomy of the parathyroid glands were developed. The obtained new data allow improving the quality of planning and carrying out operations on the thyroid and parathyroid glands, to reduce the risk of errors in diagnosis and intra-operative and post-operative complications. 220 corpses and 82 patients after surgery on the thyroid gland pathology were examined. In morphological material 4 or 5 of the parathyroid glands were found.
 Size parathyroid glands was 0,70x0,43x0,30 cm, volume - 0,0531+0,0016 cm3, and the total volume of parathyroid tissue in one case - 0,1903±0,0075 cm3. Maximum size parathyroid glands without pathologies are: 1,4x1,0x1,0 cm. On the basis of the ratio of integral indexes forms parathyroid glands were determined. The authors identified three periods of the postnatal development of human parathyroid glands: maximum growth (up to 35 years), the relative stability (36-65 years), involution (over 65 years). The revealed regularities topography are different for the «upper» of the parathyroid glands(parathyroid glands IV), located in the zones 2-3, 3 and 3-4 and to «lower» glands (parathyroid glands III) at the level of 1, 1-2, 2, 4, 5 or 5 zones. Five common variants of parathyroid glands different sizes and shapes in relation to the thyroid gland were identified. It was established that studied nosologic forms of diseases of the thyroid doesn´t affect the linear size and topography of the parathyroid glands in the frontal plane. New data on the clinical anatomy of the parathyroid glands allow to reduce the cases of intra-and postoperative complications in operations at the front of the neck.