[Surgical technique in interventions on the thyroid gland].

The thin fascial layer covering the vessels of the throat and the recurrent laryngeal nerve represents an essential structure in thyroid surgery. For protecting the parathyroid artery and the recurrent laryngeal nerve this fascia must be dissected away from the thyroid capsula propria. Incomplete dorsal dissection may leave dorsal nodes leading to recurrent goiter or recurrent autonomy, whereas penetrating the fascia may injure the recurrent laryngeal nerve and the parathyroid glands. This various handling of the covering fascia can be traced from Billroth and Kocher until today. It determines also whether the recurrent laryngeal nerve is dissected free early and completely during thyroidectomy or whether it is only located behind the fascia or through a small window.