Delphian Lymph Node Dissection: Surgical Dissection Technique as Illustrated by the Johns Hopkins Head and Neck Endocrine Surgery Division

Abstract

Introduction: The Delphian lymph node is commonly involved in thyroid cancer.1–4 It can be commonly missed as step in the surgical dissection during thyroidectomy, resulting in recurrence along the laryngotracheal skeleton and airway.5–8 The aim of our video is to highlight the significance of the Delphian lymph node and illustrate a dissection technique with technical pearls to assist endocrine surgeons in the routine dissection of this pretracheal lymph node during thyroidectomy in a patient with suspected thyroid cancer. Materials and Methods: We created a video illustrating the Delphian lymph node dissection technique during thyroidectomy in a step-by-step manner. Results: Surgical dissection of the Delphian lymph node is simple and straightforward if key anatomical landmarks are identified and surgical dissection techniques are employed. Conclusions: Delphian lymph node dissection should be a routine part of surgical dissection during thyroidectomy in suspected thyroid cancer. There is very little, if any risk, to dissection of the Delphian node to reduce the risk of recurrence on the airway. Acknowledgment: The source of this video was done through the Johns Hopkins Head and Neck Endocrine Surgery Division with no conflicts of interest or obligations. No competing financial interests exist for all the authors involved in the production of this video. Runtime of video: 4 mins 39 secs