Chakravarty Sharmistha, Aggarwal Aakash, Nagarkar Nitin M
Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India.
Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3562-3565. doi: 10.1007/s12070-024-04613-y. Epub 2024 Mar 23.
We present a case report describing an unexpected anomaly encountered during a total thyroidectomy for a patient with papillary carcinoma of the left lobe of the thyroid with retrosternal extension. Intraoperatively, we discovered that the left lobe of the thyroid gland had extended posteriorly, invading the carotid space and displacing the carotid sheath anteriorly. The vagus nerve was identified as a cord-like structure abutting the anterior surface of the tumor, in close relation to the strap muscles. This case highlights the importance of careful dissection and identification of anatomical structures during thyroidectomy procedures to avoid inadvertent nerve injury. We discuss the significance of meticulous dissection-wide exposure and advocate for greater awareness and vigilance among surgeons.
我们报告一例病例，描述了一位患有左叶甲状腺乳头状癌伴胸骨后延伸的患者在全甲状腺切除术中遇到的意外异常情况。术中，我们发现甲状腺左叶向后延伸，侵入颈动脉间隙并将颈动脉鞘向前推移。迷走神经被识别为紧邻肿瘤前表面的条索状结构，与带状肌关系密切。该病例强调了在甲状腺切除术中仔细解剖和识别解剖结构以避免意外神经损伤的重要性。我们讨论了细致解剖和广泛暴露的意义，并提倡外科医生提高认识和警惕性。
