Where should the inferior thyroid artery be ligated during thyroidectomy?
Because of extreme variability of the inferior thyroid artery and the RLN, it is suggested that the artery be ligated either proximally or at its tertiary branches on thyroid capsule. The internal branch of the SLN is not potentially at risk during thyroidectomy unless the superior thyroid artery is ligated proximally.
Which artery is ligation in thyroidectomy?
Background: Bilateral truncal ligation (BTL) of the inferior thyroid artery (ITA) is frequently used during subtotal thyroidectomy to reduce the risk of post-operative bleeding as well as to reduce the blood loss intra-operatively.
Why the inferior thyroid artery should be ligated away from the gland during operation on it?
Identification of inferior thyroid artery, careful ligation of all its branches close to the gland rather than away from it is very helpful in preventing damage to recurrent laryngeal nerve and inferior parathyroid glands.
Why is middle thyroid ligated first?
To preserve blood supply to the parathyroid glands, the inferior thyroid artery should not be ligated laterally as a single trunk; rather, its branches should be ligated individually on the capsule of the lobe after they have supplied the parathyroid glands (see Fig. 96-15, F).
Where do you Ligate superior thyroid?
Most surgeons agree that identifying the SLN, in contrast to the RLN, is unnecessary. Instead, ligate the terminal branches of the superior thyroid artery as close to the thyroid capsule as possible to avoid damaging the nerve.
Why superior thyroid artery is ligated near the gland?
The artery and nerve are close to each other higher up but diverge near the gland. Thus in order to avoid injury to the external laryngeal nerve, the superior thyroid artery is ligated as near to the gland as possible.
Which nerve is related to inferior thyroid artery?
the recurrent laryngeal nerve
At the inferior pole of the thyroid gland, the recurrent laryngeal nerve is closely related to the inferior thyroid artery.
What is the inferior thyroid artery?
The inferior thyroid artery is the largest and most significant branch of the thyrocervical trunk. It divides into the inferior and superior branches near the base of the thyroid gland, which supply the thyroid gland’s inferior and posterior surfaces.
What is a branch of inferior thyroid artery?
The branches of the inferior thyroid artery are the inferior laryngeal, the oesophageal, the tracheal, the ascending cervical and the pharyngeal arteries. The inferior laryngeal artery climbs the trachea to the back part of the larynx under cover of the inferior pharyngeal constrictor muscle.
Where do you cut the straps for a thyroidectomy?
The strap muscles may need transection if the gland is large. The muscles should be cut as high as possible as the nerve supply to these muscles (ansa cervicalis) is in the lower third [1–3].
Where does inferior thyroid artery come from?
The inferior thyroid artery (Fig. 22.7) arises from the thyrocervical trunk, which branches from the subclavian artery on the pleural dome, in front and a little lateral of the vertebral artery.