许克勒氏结节在右侧更常见且更大：一项前瞻性系列研究。
Thyroid tubercle of zuckerkandl is more consistently present and larger on the right: a prospective series.
机构信息
Department of Otolaryngology, South Infirmary Victory University Hospital, Cork, Ireland.
Department of Endocrinology, South Infirmary Victory University Hospital, Cork, Ireland.
出版信息
Eur Thyroid J. 2014 Mar;3(1):38-42. doi: 10.1159/000355823. Epub 2013 Nov 20.
OBJECTIVE
The tubercle of Zuckerkandl (TZ) is a lateral projection from the thyroid lobe in the vicinity of the extralaryngeal termination of the recurrent laryngeal nerve (RLN), which is a very useful landmark for identification of the RLN during thyroidectomy. The purpose of the present study was to test our hypothesis that the TZ is more consistently found and is larger on the right than on the left side, and to investigate the frequency of anatomic variations of the TZ.
STUDY DESIGN
Prospective cohort study of 156 consecutive patients undergoing primary total thyroidectomy at an academic teaching hospital. Thyroidectomy was performed using a capsular dissection technique, with identification of the RLN only at its entry point into the larynx, using the TZ as a landmark. In vivo recording of size of right and left TZ was performed. The size of the right and left TZ was compared.
RESULTS
Identification of the TZ was 72.6% right side and 53.9% left side (p = 0.003). The mean size of the TZ, when present, was 11.2 mm on the right and 7.5 mm on the left (p = 0.0002). In matched-pair analysis, the right TZ was significantly larger than the left TZ (p < 1 × 10(-7)). The TZ overlay the RLN in nearly all cases; however, there were 2 cases (0.8%) of a TZ extending medial to the RLN. In 12 cases (4.7%), the TZ appeared as a bilobed structure.
CONCLUSION
The right TZ is consistently larger and more often identified than the left.
目的
甲状旁腺结节（TZ）是甲状腺叶附近喉外返神经（RLN）终点处的一个侧突，是甲状腺切除术识别 RLN 的非常有用的标志。本研究旨在验证我们的假设，即 TZ 在右侧比左侧更一致地发现且更大，并探讨 TZ 的解剖变异频率。
研究设计
在一家学术教学医院对 156 例连续行原发性全甲状腺切除术的患者进行前瞻性队列研究。采用囊内解剖技术行甲状腺切除术，仅在 RLN 进入喉部的入口处识别 RLN，以 TZ 为标志。对右侧和左侧 TZ 的大小进行活体记录。比较右侧和左侧 TZ 的大小。
结果
右侧 TZ 的识别率为 72.6%，左侧为 53.9%（p = 0.003）。当存在 TZ 时，右侧 TZ 的平均大小为 11.2mm，左侧为 7.5mm（p = 0.0002）。在配对分析中，右侧 TZ 明显大于左侧 TZ（p < 1×10(-7)）。TZ 在几乎所有情况下都覆盖 RLN；然而，有 2 例（0.8%）TZ 延伸至 RLN 内侧。在 12 例（4.7%）中，TZ 表现为双叶结构。
结论
右侧 TZ 始终比左侧更大且更常被识别。
Zotero 插件