The Middle Thyroid Vein: Anatomical and Surgical Aspects

Abstract

An issue that has been overlooked in medical literature concerns the prevalence and topographic relationships of the middle thyroid vein (MTV), which have been studied, with a prospective approach, in patients with various thyroid diseases. MTV prevalence has been investigated in 394 consecutive lobes and a number of different variables (age, gender, thyroid pathology, gland weight) have been considered. Moreover, in cooperation with our Human Morphology Department, we brought to completion a dedicated anatomy report, with the clear objective of providing a detailed anatomic description of MTV. The prevalence of MTV was 38% of the dissected lobes and 62% of operated patients. Most veins arise from the mid region of the thyroid lobe (80%): B, 3, and 2 positions in accordance with our scheme. As far as thyroid pathology is concerned, we found that the presence of MTV was more frequent in hyperthyroidism and large goiters (p < 0.05). A better understanding of the anatomic variability in MTV may be useful not only to minimize the risk of bleeding, but it also can help to perform a more accurate dissection with the goal of preserving the laryngeal nerves and parathyroid glands, especially because of its location and relationships with other adjacent structures.