How are the parathyroid glands identified in a thyroidectomy?

1. Giddings AE. The history of thyroidectomy. J R Soc Med. 1998. 91 Suppl 33:3-6. [Medline].

2. Pinchot S, Chen R, Sippel R. Incisions and Exposure of the Neck for Thyroidectomy and Parathyroidectomy. Operative Techniques in General Surgery. June/2008. 10:63-76. [Full Text].

3. Jancewicz S, Sidhu S, Jalaludin B, Campbell P. Optimal position for a cervical collar incision: a prospective study. ANZ J Surg. 2002 Jan. 72(1):15-7. [Medline].

4. Lai, SY; Mandel, SJ; Weber RS. Management of Thyroid Neoplasms. Flint, P; Haughey, BH; Lund, VJ; Niparko, JK; Richardson, MA. Flint: Cummings Otolaryngology: Head & Neck Surgery, 5th ed. 5th. 2010. Ch. 124.

5. Myers, Eugene. Thyroidectomy. Myers, Eugene. Operative Otolaryngology: Head and Neck Surgery. 2nd. Ch. 65.

6. Owen RP, Chou KJ, Silver CE, Beilin Y, Tang JJ, Yanagisawa RT, et al. Thyroid and parathyroid surgery in pregnancy. Eur Arch Otorhinolaryngol. 2010 Dec. 267(12):1825-35. [Medline].

7. Kuy S, Roman SA, Desai R, Sosa JA. Outcomes following thyroid and parathyroid surgery in pregnant women. Arch Surg. 2009 May. 144(5):399-406; discussion 406. [Medline].

8. Fancy T, Gallagher D 3rd, Hornig JD. Surgical anatomy of the thyroid and parathyroid glands. Otolaryngol Clin North Am. 2010 Apr. 43(2):221-7, vii. [Medline]. [Full Text].

9. Bliss RD, Gauger PG, Delbridge LW. Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg. 2000 Aug. 24(8):891-7. [Medline].

10. Krudy AG, Doppman JL, Brennan MF. The significance of the thyroidea ima artery in arteriographic localization of parathyroid adenomas. Radiology. 1980 Jul. 136(1):51-45. [Medline]. [Full Text].

11. Munck, K; Eisele, D. Parathyroid Disorders. Lalwani, AK. Current Diagnosis and Treatment in Otolaryngology - Head and Neck Surgery. 2nd. McGraw Hill; 2008. 572-576.

12. Leow CK, Webb AJ. The lateral thyroid ligament of Berry. Int Surg. 1998 Jan-Mar. 83(1):75-8. [Medline].

13. Nemiroff PM, Katz AD. Extralaryngeal divisions of the recurrent laryngeal nerve. Surgical and clinical significance. Am J Surg. 1982 Oct. 144(4):466-9. [Medline]. [Full Text].

14. van der Molen AJ, Thomsen HS, Morcos SK. Effect of iodinated contrast media on thyroid function in adults. Eur Radiol. 2004 May. 14(5):902-7. [Medline].

15. Laurie AJ, Lyon SG, Lasser EC. Contrast material iodides: potential effects on radioactive iodine thyroid uptake. J Nucl Med. 1992 Feb. 33(2):237-8. [Medline].

16. Eisele DW. Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve. Laryngoscope. 1996 Apr. 106(4):443-9. [Medline].

17. Cavicchi O, Caliceti U, Fernandez IJ, Macrì G, Di Lieto C, Marcantoni A, et al. The value of neurostimulation and intraoperative nerve monitoring of inferior laryngeal nerve in thyroid surgery. Otolaryngol Head Neck Surg. 2009 Jun. 140(6):866-70. [Medline].

18. Choby G, Hollenbeak CS, Johnson S, Goldenberg D. Surface electrode recurrent laryngeal nerve monitoring during thyroid surgery: normative values. J Clin Neurophysiol. 2010 Feb. 27(1):34-7. [Medline].

19. Donnellan KA, Pitman KT, Cannon CR, Replogle WH, Simmons JD. Intraoperative laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg. 2009 Dec. 135(12):1196-8. [Medline].

20. Goretzki PE, Schwarz K, Brinkmann J, Wirowski D, Lammers BJ. The impact of intraoperative neuromonitoring (IONM) on surgical strategy in bilateral thyroid diseases: is it worth the effort?. World J Surg. 2010 Jun. 34(6):1274-84. [Medline].

21. Kowalski LP, Sanabria A, Vartanian JG, Lima RA, Toscano de Mendonca UB, Roberto Dos Santos C, et al. Total thyroidectomy with ultrasonic scalpel: A multicenter, randomized controlled trial. Head Neck. 2012 Feb 2. [Medline].

22. Gauger PG, Delbridge LW, Thompson NW, Crummer P, Reeve TS. Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery. Eur J Surg. 2001 Apr. 167(4):249-54. [Medline].

23. Gravante G, Delogu D, Rizzello A, Filingeri V. The Zuckerkandl tubercle. Am J Surg. 2007 Apr. 193(4):484-5. [Medline].

24. Yun JS, Lee YS, Jung JJ, Nam KH, Chung WY, Chang HS. The Zuckerkandl's tubercle: a useful anatomical landmark for detecting both the recurrent laryngeal nerve and the superior parathyroid during thyroid surgery. Endocr J. 2008 Oct. 55(5):925-30. [Medline]. [Full Text].

25. Veyseller B, Aksoy F, Yildirim YS, Karatas A, Ozturan O. Effect of recurrent laryngeal nerve identification technique in thyroidectomy on recurrent laryngeal nerve paralysis and hypoparathyroidism. Arch Otolaryngol Head Neck Surg. 2011 Sep. 137(9):897-900. [Medline].

26. Sasou S, Nakamura S, Kurihara H. Suspensory ligament of Berry: its relationship to recurrent laryngeal nerve and anatomic examination of 24 autopsies. Head Neck. 1998 Dec. 20(8):695-8. [Medline].

27. Terris DJ. Minimally invasive thyroidectomy: an emerging standard of care. Minerva Chir. 2007 Oct. 62(5):327-33. [Medline].

28. Miccoli P, Materazzi G, Berti P. Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg. 2010 Apr. 18(2):114-8. [Medline]. [Full Text].

29. Radford PD, Ferguson MS, Magill JC, Karthikesalingham AP, Alusi G. Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope. 2011 Aug. 121(8):1675-81. [Medline].

30. Byrd JK, Nguyen SA, Ketcham A, Hornig J, Gillespie MB, Lentsch E. Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: a cost-effective analysis. Otolaryngol Head Neck Surg. 2010 Dec. 143(6):789-94. [Medline].

31. Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS. Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc. 2009 Nov. 23(11):2399-406. [Medline].

32. Terris DJ, Singer MC, Seybt MW. Robotic facelift thyroidectomy: II. Clinical feasibility and safety. Laryngoscope. 2011 Aug. 121(8):1636-41. [Medline].

33. Randolph GW, Shin JJ, Grillo HC, Mathisen D, Katlic MR, Kamani D. The surgical management of goiter: Part II. Surgical treatment and results. Laryngoscope. 2011 Jan. 121(1):68-76. [Medline].

34. Shaha AR. Revision thyroid surgery - technical considerations. Otolaryngol Clin North Am. 2008 Dec. 41(6):1169-83, x. [Medline].

35. Pai SI, Tufano RP. Reoperation for recurrent/persistent well-differentiated thyroid cancer. Otolaryngol Clin North Am. 2010 Apr. 43(2):353-63, ix. [Medline].

36. Terris DJ, Khichi S, Anderson SK, Seybt MW. Reoperative thyroidectomy for benign thyroid disease. Head Neck. 2010 Mar. 32(3):285-9. [Medline].

37. Johnson S, Goldenberg D. Intraoperative monitoring of the recurrent laryngeal nerve during revision thyroid surgery. Otolaryngol Clin North Am. 2008 Dec. 41(6):1147-54, ix. [Medline].

38. Ruggiero FP, Fedok FG. Outcomes in reoperative thyroid cancer. Otolaryngol Clin North Am. 2008 Dec. 41(6):1261-8, xii. [Medline]. [Full Text].

39. Terris DJ, Moister B, Seybt MW, Gourin CG, Chin E. Outpatient thyroid surgery is safe and desirable. Otolaryngol Head Neck Surg. 2007 Apr. 136(4):556-9. [Medline].

40. Fahad Al-Dhahri S, Al-Ghonaim YA, Sulieman Terkawi A. Accuracy of postthyroidectomy parathyroid hormone and corrected calcium levels as early predictors of clinical hypocalcemia. J Otolaryngol Head Neck Surg. 2010 Aug. 39(4):342-8. [Medline].

41. Graff AT, Miller FR, Roehm CE, Prihoda TJ. Predicting hypocalcemia after total thyroidectomy: parathyroid hormone level vs. serial calcium levels. Ear Nose Throat J. 2010 Sep. 89(9):462-5. [Medline].

42. Nomura K, Yamashita J, Ogawa M. Endothelin-1 is involved in the transient hypoparathyroidism seen in patients undergoing thyroid surgery. J Endocrinol. 1994 Nov. 143(2):343-51. [Medline].

43. Edafe O, Antakia R, Laskar N, Uttley L, Balasubramanian SP. Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia. Br J Surg. 2014 Mar. 101 (4):307-20. [Medline].

44. Gourin CG, Tufano RP, Forastiere AA, Koch WM, Pawlik TM, Bristow RE. Volume-based trends in thyroid surgery. Arch Otolaryngol Head Neck Surg. 2010 Dec. 136(12):1191-8. [Medline].

45. Stavrakis AI, Ituarte PH, Ko CY, Yeh MW. Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery. Surgery. 2007 Dec. 142(6):887-99; discussion 887-99. [Medline].

46. Watkinson JC. Fifteen years' experience in thyroid surgery. Ann R Coll Surg Engl. 2010 Oct. 92(7):541-7. [Medline].

Neerav Goyal, MD, MPH Assistant Professor of Surgery, Director of Head and Neck Surgery, Division of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center

Neerav Goyal, MD, MPH is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Nothing to disclose.

David Goldenberg, MD, FACS Chief of Otolaryngology-Head and Neck Surgery, Professor of Surgery and Oncology, Pennsylvania State University College of Medicine; Director of Head and Neck Surgery, Department of Surgery, Division of Otolaryngology-Head and Neck Oncology, Milton S Hershey Medical Center

David Goldenberg, MD, FACS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, American Thyroid Association, Israeli Medical Association

Disclosure: Nothing to disclose.

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;The Physicians Edge;Sync-n-Scale;mCharts<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; .