Surgical Technique for Preservation of Inferior Parathyroid Gland

Abstract

Objectives: The inferior parathyroid glands receive blood supply from the inferior thyroid artery. The anatomic relationship of the inferior thyroid artery and recurrent laryngeal nerve (RLN) can be described in 3 different patterns. We reconsidered the anatomic relationship of these structures and mentioned the method to maintain vascular supply of inferior parathyroid gland during central neck dissection (CND) according to their anatomical relationship. Methods: For removal of fibrofatty tissue in central neck compartment, dissection proceeds along RLN. During the process, surgeons should be careful not to injure the inferior parathyroid gland. Results: To preserve the inferior parathyroid gland, dissection should proceed along RLN in the medial side of inferior parathyroid gland, if inferior parathyroid gland usually receives blood supply from posterolateral vascular pedicle. In cases in which inferior thyroid artery travels deep to right RLN and right parathyroid gland receives blood supply from posteromedial vascular pedicle, CND should be carefully performed along the lateral side of inferior parathyroid gland to preserve posteromedial vascular pedicle. Conclusions: To preserve the function of inferior parathyroid gland, the anatomical relationship between inferior thyroid artery and RLN should be understood. The direction of dissection along the RLN should be changed according to their anatomical pattern.