Classification of External branch of superior laryngeal nerve Cernea classification 2. Recurrent Laryngeal Nerve This nerve has been studied extensively, being more closely linked with thyroid surgery, was first described by Galen in the second century. The tubercle along with the pyramidal lobe seen in the specimen. Tubercle of Zuckerkandl - the nerve lies deep and medial to the tubercle of Zuckerkandl Recurrent laryngeal nerve and inferior thyroid artery - Nerve lies deep to the artery Galen's Loop - rarely the sensory branch of the recurrent laryngeal nerve may join the internal branch of superior laryngeal nerve to form Galen's loop. National Center for Biotechnology InformationU. Arch Otolaryngol Head Neck Surg Type 2: The nerve penetrates the lower part of the inferior constrictor muscle.
The ipsilateral lobe is given traction in a downward and outward direction thus opening up the sternothyroid—laryngeal triangle or “Jolls. Assessing the Usefulness of Simon's and Joll's Triangles in Thyroidectomy.
Conference Paper (PDF Available) · July with 8, Reads. Introduction: Thyroid surgery defines a surgeon's precision. Keywords: Thyroidectomy, RLN, Complication of thyroid surgery, Triangles in Joll's Triangle.
Billroth initially and Lahey later insisted that the RLN must be seen and preserved in all cases.
Tubercle of Zuckerkandl - the nerve lies deep and medial to the tubercle of Zuckerkandl.
The nerve should not be skeleteonized as it may produce ischemic damage. Mass ligature i. The superior thyroid artery and vein that divide into anterior and posterior branches.
Video: Thyroidectomy jolls triangle Thyroid Surgery (Thyroidectomy)
Parti-. Figure RLN crossing Simon's triangle formed by.
The Type 3 variant may account for the fact that many authors state that the nerve could not be identified in the region of the upper pole of the thyroid gland during thyroid surgery.
This anomaly is indeed the friend of a surgeon and a reliable guide to the RLN [ 3 ].
The approach needs to be tailored to the individual case and training of the surgeon. Inferior approach is useful when dealing with large goiter or recurrence.
Non-recurrent laryngeal nerve is very rarely seen 0. One has to very carefully dissect the branches distal to the supply to parathyroid glands.
KITE SURFING VICTORIA AUSTRALIA MAP
|One only ligates the capsular branches of this artery. The sternothyrolaryngeal triangle of Joll is formed laterally by the upper pole of the thyroid gland and the superior thyroid vessels, superiorly by the attachment of the strap muscles to the thyroid cartilage and medially by the midline.
'father of modern thyroid surgery', but the first thyroidectomy was done more. of Joll's triangle (Figure 5) is achieved by superior and lateral retraction of the.
Thyroidectomy; Inferior constrictor of pharynx; cricothyroid muscle. Introduction.
Medicowesome Joll's triangle in thyroidectomy
Though all. Maran, the nerve lies in the Joll's triangle .
These branches are ligated individually and as close to thyroid as possible.
Support Center Support Center. Classification of External branch of superior laryngeal nerve Cernea classification 2 Type I - most common presentation - nerve crossing the superior thyroid vessels approximately 1 cm or more above a horizontal plane passing thryough the upper border of superior thyroid pole. One may not have to make a deliberate attempt at searching unless the nerve does not show up in the routine progress of capsular dissection. Patients following surgery for thyroid must always undergo a quality of voice assessment and also indirect laryngoscopy as the damage may not always be very apparent.
External laryngeal nerve in thyroid surgery: recognition and surgical implications. Pawan Lal, Prof.
Thyroidectomy jolls triangle
|In case of damage to this nerve, there are distinct features revealed on indirect laryngoscopy [ vocal cord is shorterhyperemicand may be at a lower levelglottic chink may be oblique due to rotation of posterior commissure to paralyzed side].
Type I - most common presentation - nerve crossing the superior thyroid vessels approximately 1 cm or more above a horizontal plane passing thryough the upper border of superior thyroid pole. The inferior prarathyroid is dissected away rom the inferior pole and the nerve is sheen as white shiny structure that feels like a string of a guitar.
This approach is technically more challenging. This approach involves identification of the nerve at thoracic inlet where it is often sighted in the RLN triangle [ apex of triangle inferiorly formed by thoracic inlet, trachea medially and laterally the medial edge of retracted strap muscles while superiorly by the lower edge of the inferior pole ].