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Evaluation of thyroid Zuckerkandl tubercle by computed tomography

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Abstract

Purpose

This study investigated the incidence of thyroid Zuckerkandl Tubercle (ZT) using a computed tomography (CT) scan of the neck with contrast to identify the typologies in ZT-positive CT scans, investigate the presence of nodules located in that area, and compare the results with the relevant literature.

Methods

We selected and retrospectively examined the CT scan images of patients who presented to our clinic with CT scans of the neck with contrast that clearly showed thyroid tissue and boundaries. Patients were evaluated based on age, gender, and presence of thyroid ZT. Patients with thyroid ZT were further investigated for localization and type of tubercles as well as for presence of nodules at the tubercle level.

Results

A total of 1000 patients (mean age: 48.4 ± 19.1) were included in the study. Out of the total 222 (22.2%) patients who had thyroid ZT, 134 (60.4%) patients had unilateral thyroid ZT on the right side and 29 (13.1%) patients had unilateral thyroid ZT on the left side; 59 (26.6%) patients had bilateral thyroid ZT. In addition, nodules at the ZT level were observed in 13 (1.3%) of the patients. A review of all cases with ZTs indicated that 63% were Type 1, 31% were Type 2, and 5% were Type 3.

Conclusion

During the thyroid operations, ZT is essential for locating the recurrent laryngeal nerve. Reporting the presence of ZTs based on CT scans is crucial because it can prevent unnecessary interventional procedures, misdiagnoses, and likely complications in patients with planned thyroid operations.

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References

  1. Gil-Carcedo E, Menéndez ME, Vallejo LA et al (2013) The Zuckerkandl tubercle: problematic or helpful in thyroid surgery? Eur Arch Otorhinolaryngol 270:2327–2332

    Article  Google Scholar 

  2. Gil-Carcedo Sañudo E, Menéndez Argüelles ME, Vallejo Valdezate LÁ et al (2012) Zuckerkandl’s tubercle. Location, shape and dimensions. Acta Otorrinolaringol Esp 63:443–149

    Article  Google Scholar 

  3. Irkorucu O (2016) Zuckerkandl tubercle in thyroid surgery: is it a reality or a myth? Ann Med Surg (Lond) 7:92–96

    Article  Google Scholar 

  4. Kaisha W, Wobenjo A, Saidi H (2011) Topography of the recurrent laryngeal nerve in relation to the thyroid artery, Zuckerkandl tubercle, and berry ligament in Kenyans. Clin Anat 24:853–857

    Article  CAS  Google Scholar 

  5. Lee TC, Selvarajan SK, Curtin H, Mukundan S (2012) Zuckerkandl tubercle of the thyroid: a common imaging finding that may mimic pathology. AJNR Am J Neuroradiol 33:1134–1138

    Article  CAS  Google Scholar 

  6. Page C, Cuvelier P, Biet A et al (2009) Thyroid tubercle of Zuckerkandl: anatomical and surgical experience from 79 thyroidectomies. J Laryngol Otol 123:768–771

    Article  CAS  Google Scholar 

  7. Pelizzo MR, Toniato A, Gemo G (1998) Zuckerkandl’s tuberculum: an arrow pointing to the recurrent laryngeal nerve (constant anatomical landmark). J Am Coll Surg 187:333–336

    Article  CAS  Google Scholar 

  8. Rajapaksha A, Fernando R, Ranasinghe N et al (2015) Morphology of the tubercle of Zuckerkandl and its importance in thyroid surgery. Ceylon Med J 60:23–24

    Article  CAS  Google Scholar 

  9. Sheahan P, Murphy MS (2011) Thyroid tubercle of Zuckerkandl: importance in thyroid surgery. Laryngoscope 121:2335–2337

    Article  Google Scholar 

  10. Won HS, Liu HF, Kim JH et al (2015) Zuckerkandl’s tubercle of the thyroid gland: its location in the anatomical position, and comparative morphology of the same specimens before and after fixation. Clin Anat 28:472–476

    Article  Google Scholar 

  11. Won HJ, Won HS, Kwak DS et al (2017) Zuckerkandl tubercle of the thyroid gland: correlations between findings of anatomical dissections and CT imaging. AJNR Am J Neuroradiol 38:1416–1420

    Article  Google Scholar 

  12. Yun JS, Lee YS, Jung JJ et al (2008) The Zuckerkandl’s tubercle: a useful anatomical landmark for detecting both the recurrent laryngeal nerve and the superior parathyroid during thyroid surgery. Endocr J 55:925–930

    Article  Google Scholar 

  13. Zuckerkandl E. (1902) Nebst Bemerkungen über die Epithelkorperchen des Menschen. Anat Hefte: 61

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Acknowledgements

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

Authors

Contributions

MAD and İA: project development, data collection, and manuscript writing. MT: data collection. SH: data collection and manuscript writing. MT: statistical analysis.

Corresponding author

Correspondence to Muhammed Akif Deniz.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee as well as the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Local ethics committee approval was obtained before starting the study (Ethics Committee for Non-Interventional Clinical Research, Faculty of Medicine, Dicle University; Date: February 15, 2022 No.: 21).

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Informed consent was obtained from all the individual participants included in the study.

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All the patients provided signed informed consents for publishing their data and photographs.

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Deniz, M.A., Turmak, M., Hattapoğlu, S. et al. Evaluation of thyroid Zuckerkandl tubercle by computed tomography. Surg Radiol Anat 44, 907–912 (2022). https://doi.org/10.1007/s00276-022-02963-2

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  • DOI: https://doi.org/10.1007/s00276-022-02963-2

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