Baker Aaron, Cottrill Elizabeth E, Munizza Olivia, McGillen Kathryn, McKinnon Tyler, Goldenberg David
Department of Surgery, Division of Otolaryngology - Head and Neck Surgery The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Head Neck. 2017 Dec;39(12):E123-E126. doi: 10.1002/hed.24970. Epub 2017 Oct 11.
When performing thyroidectomy, knowledge of normal anatomy and variants is vital to avoid injuring nearby structures. Typically, the bilateral carotids course posterolateral to the thyroid gland. We describe a rare variant of an intrathyroidal carotid artery, not previously described in the literature.
A 23-year-old woman with a strong family history of thyroid cancer presented with a left thyroid nodule, and a fine-needle aspiration biopsy revealing papillary thyroid carcinoma. She underwent total thyroidectomy.
Intraoperatively, the carotid was found coursing centrally through the right lobe parenchyma, associated with an ipsilateral nonrecurrent recurrent laryngeal nerve (NRLN) entering the cricothyroid joint superolaterally.
This is, to our knowledge, the first report of such an anatomic variant in the medical literature. Aberrant carotid artery anatomy may potentially cause life-threatening surgical complications and should be considered preoperatively. Furthermore, recognition of concurrent recurrent laryngeal nerve (RLN) anomalies with vascular variations allows identification of nonrecurrent nerves.
在进行甲状腺切除术时，了解正常解剖结构及其变异对于避免损伤附近结构至关重要。通常，双侧颈动脉走行于甲状腺的后外侧。我们描述了一种罕见的甲状腺内颈动脉变异，此前文献中未见报道。
一名有甲状腺癌家族史的23岁女性因左侧甲状腺结节就诊，细针穿刺活检显示为甲状腺乳头状癌。她接受了全甲状腺切除术。
术中发现颈动脉从右侧叶实质中央穿过，伴有一条同侧非返行性喉返神经（NRLN）从后上外侧进入环甲关节。
据我们所知，这是医学文献中首次报道这种解剖变异。异常的颈动脉解剖结构可能会导致危及生命的手术并发症，术前应予以考虑。此外，认识到喉返神经（RLN）异常与血管变异并存有助于识别非返行神经。
