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Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance.

Ha EJ, Baek JH, Lee JH - Korean J Radiol (2015)

Bottom Line: For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential.Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures.Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University School of Medicine, Suwon 443-380, Korea.

ABSTRACT
Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions.

No MeSH data available.


Relationship of superior laryngeal nerves to adjacent anatomic structures.A. Schematic drawing shows superior laryngeal nerve course. B-D. On transverse scan, metastatic lymph node (M) is seen at level of thyroid cartilage. Although superior laryngeal nerve is not directly visualized on ultrasonography, its location can be expected near superior thyroid vessels (arrows). eSLN = external branch of superior laryngeal nerve, iSLN = internal branch of superior laryngeal nerve, RLN = recurrent laryngeal nerve, STA = superior thyroid artery, STV = superior thyroid vein
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Figure 8: Relationship of superior laryngeal nerves to adjacent anatomic structures.A. Schematic drawing shows superior laryngeal nerve course. B-D. On transverse scan, metastatic lymph node (M) is seen at level of thyroid cartilage. Although superior laryngeal nerve is not directly visualized on ultrasonography, its location can be expected near superior thyroid vessels (arrows). eSLN = external branch of superior laryngeal nerve, iSLN = internal branch of superior laryngeal nerve, RLN = recurrent laryngeal nerve, STA = superior thyroid artery, STV = superior thyroid vein

Mentions: The superior laryngeal nerve (SLN) is a branch of the vagus nerve that is separated high in the neck. It descends in the neck adjacent to the pharynx, medial to the carotid sheath, and divides into the internal and external branches approximately 2-3 cm superior to the thyroid gland. It then enters the vocal cord through the cricothyroid membrane (Fig. 8). The external branch supplies the cricothyroid muscles, and injury to the nerve changes the pitch of the voice and causes an inability to make explosive sounds. Although it is not visible on US, its location could be expected near the superior thyroidal artery and vein at the superior aspect of the thyroid gland. Therefore, attention to SLN injury is necessary when treating recurrent tumors medial to the superior thyroidal artery at the upper pole of the thyroid gland during RF ablation (Fig. 8). The internal branch dominates sensory sensation above the vocal cord, and is located between the greater horn of the hyoid bone and thyroid cartilage just above the thyrohyoid membrane. SLN block may be performed using these anatomic landmarks (38).


Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance.

Ha EJ, Baek JH, Lee JH - Korean J Radiol (2015)

Relationship of superior laryngeal nerves to adjacent anatomic structures.A. Schematic drawing shows superior laryngeal nerve course. B-D. On transverse scan, metastatic lymph node (M) is seen at level of thyroid cartilage. Although superior laryngeal nerve is not directly visualized on ultrasonography, its location can be expected near superior thyroid vessels (arrows). eSLN = external branch of superior laryngeal nerve, iSLN = internal branch of superior laryngeal nerve, RLN = recurrent laryngeal nerve, STA = superior thyroid artery, STV = superior thyroid vein
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499539&req=5

Figure 8: Relationship of superior laryngeal nerves to adjacent anatomic structures.A. Schematic drawing shows superior laryngeal nerve course. B-D. On transverse scan, metastatic lymph node (M) is seen at level of thyroid cartilage. Although superior laryngeal nerve is not directly visualized on ultrasonography, its location can be expected near superior thyroid vessels (arrows). eSLN = external branch of superior laryngeal nerve, iSLN = internal branch of superior laryngeal nerve, RLN = recurrent laryngeal nerve, STA = superior thyroid artery, STV = superior thyroid vein
Mentions: The superior laryngeal nerve (SLN) is a branch of the vagus nerve that is separated high in the neck. It descends in the neck adjacent to the pharynx, medial to the carotid sheath, and divides into the internal and external branches approximately 2-3 cm superior to the thyroid gland. It then enters the vocal cord through the cricothyroid membrane (Fig. 8). The external branch supplies the cricothyroid muscles, and injury to the nerve changes the pitch of the voice and causes an inability to make explosive sounds. Although it is not visible on US, its location could be expected near the superior thyroidal artery and vein at the superior aspect of the thyroid gland. Therefore, attention to SLN injury is necessary when treating recurrent tumors medial to the superior thyroidal artery at the upper pole of the thyroid gland during RF ablation (Fig. 8). The internal branch dominates sensory sensation above the vocal cord, and is located between the greater horn of the hyoid bone and thyroid cartilage just above the thyrohyoid membrane. SLN block may be performed using these anatomic landmarks (38).

Bottom Line: For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential.Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures.Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University School of Medicine, Suwon 443-380, Korea.

ABSTRACT
Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions.

No MeSH data available.