Central Compartment Neck Dissection for Well-Differentiated Thyroid Cancer

Abstract

Introduction: Central compartment neck dissection plays an important role in the appropriate treatment of metastatic papillary thyroid cancer at initial presentation and also in cases of recurrent disease. Surgeons caring for this group of patients should have familiarity and skill with this procedure. Case: A 31-year-old woman was found to have a 5-cm right thyroid lobe nodule with a fine-needle aspiration biopsy revealing papillary thyroid cancer. There was clinical evidence on ultrasound of central compartment lymphadenopathy and also right lateral neck lymphadenopathy, which was confirmed by fine-needle aspiration of a level 4 and level 6 lymph node to be metastatic papillary thyroid cancer. The patient underwent a total thyroidectomy and right central compartment neck dissection with excision of the prelaryngeal, pretracheal, and right paratracheal nodal regions. A right lateral neck dissection was also performed and included levels 2a, 2b, 3, 4, and 5. Conclusion: This video illustrates the technique of total thyroidectomy and right central compartment neck dissection with preservation of the right superior and inferior parathyroid glands and the right recurrent laryngeal nerve. There were no complications during the procedure. Postoperative fiberoptic laryngoscopy revealed bilateral true vocal fold mobility. At 3 months of follow-up, the patient was eucalcemic. Ralph P. Tufano, Consulting–Medtronic, Inc., Minneapolis, Minnesota. The authors report no other conflicts of interest. Running time of video: 10 mins, 53 secs