چکیده (انگلیسی):

Background: Zuckerkandl tubercle (ZT) is a lateral projection from the lateral thyroid lobe which is a
constant landmark for finding the recurrent laryngeal nerve during thyroid surgery. It is the condensed
thyroid parenchyma located in the cricothyroid junction. Even today, ZT and its relationship with
recurrent laryngeal nerve (RLN) is not well known by all surgeons. The objectives of the present study
were to find out the incidence of ZT in our thyroidectomies and to investigate whether the ZT has a
relationship with RLN. We also discussed how to prevent RLN injury during thyroidectomy.
Materials and methods: One hundred operations were performed by the same surgeon included in this
study. All operations performed with intraoperative neuromonitorization (IONM) for proving the visualization
of RLN. In each patient, particularly the ZT and its relationship with RLN searched and recorded.
We also analyzed the patients in terms of sex, age, clinical diagnosis, and types of performed operations.
Results: In 100 operations, 173 thyroid lobectomies were considered. 87 of these lobectomies were in
right side and 86 in left side. The ZT was determined in 127 of 173 (73.41%) lobectomies. ZT was detected
in 68 (78.16%) of right thyroid lobes whereas in 59 (68.60%) of left thyroid lobes. We observed that the ZT
was detected more frequently in the right side. In 115 (90.55%) of these occasions, the recurrent nerve
was directed upwards covered by the ZT.
Conclusions: If it is present, ZT is a real constant landmark pointing to the RLN. In order to find and
protect RLN during thyroid surgery, a careful, bloodless, and meticulous dissection should be carried out
around the ZT. Although our results are encouraging, further researches are still needed on this topic.