Abstract
The tubercle of Zuckerkandl (ZT) is an embryological remnant of the thyroid gland. Its close relationship to the recurrent laryngeal nerve (RLN) makes it an important surgical landmark. Presence and size of the ZT was prospectively assessed during thyroidectomies done at a single surgical unit during 2013. Eighty patients were included in the study. Closest distance and relationship of the ZT to the RLN was measured. Median age was 48 years (range 20-75 years). The ZT was present in 72 (90%) patients at least on one side and 55 (69%) patients on both sides. Grade III tubercles were found in 17 (21.25%) patients. Average distance between RLN and the ZT was 1.2 mm posteriorly or posteromedially. In the majority (79%) RLN was lying at a distance of ≤1 mm. Pressure symptoms were present in 19 (23.75%) patients and it was not related to the presence of grade III tubercles (p = 0.207).
Highlights
The tubercle of Zuckerkandl (ZT), first described in 1902 by Emil Zuckerkandl is an embryological remnant of the thyroid gland
It is a useful landmark to identify the recurrent laryngeal nerve (RLN). This implies that RLN may be damaged if the tubercle is not identified and carefully dealt with
Complete excision of the tubercle is important as unresected tubercles are a common cause for recurrence of goitre following thyroidectomy
Summary
The tubercle of Zuckerkandl (ZT), first described in 1902 by Emil Zuckerkandl is an embryological remnant of the thyroid gland. It is commonly seen as a thickening or a nodule in the posterior aspect of the gland. The surgical importance of the tubercle was not initially appreciated until its close relationship to the recurrent laryngeal nerve (RLN) was recognized. It is a useful landmark to identify the RLN. This implies that RLN may be damaged if the tubercle is not identified and carefully dealt with. Complete excision of the tubercle is important as unresected tubercles are a common cause for recurrence of goitre following thyroidectomy. Studies have shown an association between pressure symptoms and enlarged tubercles [1]
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