👉The Tubercle of Zuckerkandl (TZ) is not only an important landmark, but also if not properly identified and carefully dissected, increases the chances of recurrent laryngeal nerve (RLN) injury. The new concept of a fascial plane separating the TZ and RLN reinforces the importance of identification TZ for safe dissection of the parathyroid glands and the RLN.
👉There is a fascial sleeve extending from the posterior ‘V’ lip of the superior pole of thyroid which passes posteriorly. This on anteromedial rotation becomes the superficial vascular fascial layer. This encloses the TZ.
👉Tubercle of Zuckerkandl is both the pointer to the RLN and also separates the superior and inferior parathyroid gland.
👉In this situation, it is necessary to mobilize TZ and also rotate it almost 180 degrees anteriorly and medially to expose the RLN and also for the safe dissection of parathyroid glands.
👉It works as a maker and a tool for safe thyroid surgery. In the changing paradigm of thyroid surgery, the TZ, which was an inconstant landmark has now become a constant landmark for identification of RLN.
👉The thyroid surgeon should be aware that it is more consistently found, usually larger on the right with anatomical variations and also might result in pressure symptoms especially in small goiters and becomes a friend as the surgeon experience increases.
👉Saba Retnam et al. World Journal of Endocrine Surgery May 2015
My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida.
I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016.
Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida.
Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 