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An Unusual Case of Anterior Displacement of the Vagus Nerve during Total Thyroidectomy: A Surgical Dilemma

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Abstract

We present a case report describing an unexpected anomaly encountered during a total thyroidectomy for a patient with papillary carcinoma of the left lobe of the thyroid with retrosternal extension. Intraoperatively, we discovered that the left lobe of the thyroid gland had extended posteriorly, invading the carotid space and displacing the carotid sheath anteriorly. The vagus nerve was identified as a cord-like structure abutting the anterior surface of the tumor, in close relation to the strap muscles. This case highlights the importance of careful dissection and identification of anatomical structures during thyroidectomy procedures to avoid inadvertent nerve injury. We discuss the significance of meticulous dissection-wide exposure and advocate for greater awareness and vigilance among surgeons.

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India

    Sharmistha Chakravarty

  2. Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India

    Aakash Aggarwal

  3. Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India

    Nitin M. Nagarkar

Authors
  1. Sharmistha Chakravarty
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  2. Aakash Aggarwal
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  3. Nitin M. Nagarkar
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Contributions

AA and SC: Concept,design, Literature search,Writing; AA :Concept, Analysis and/or interpretations; NMN and SC: Supervision, Critical Review.

Corresponding author

Correspondence to Aakash Aggarwal.

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Chakravarty, S., Aggarwal, A. & Nagarkar, N.M. An Unusual Case of Anterior Displacement of the Vagus Nerve during Total Thyroidectomy: A Surgical Dilemma. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04613-y

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  • DOI: https://doi.org/10.1007/s12070-024-04613-y

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