Thyroid mini-access on the anterior surface of the neck (anatomo-clinical study)

Tatarkin VV, Trunin EM, Dydykin SS, et al. Thyroid mini-access on the anterior surface of the neck (anatomo-clinical study). Russian Journal of Operative Surgery and Clinical Anatomy. 2025;9(3):29‑40. (In Russ.)
https://doi.org/10.17116/operhirurg2025903129

Подписка 2026 Оперативная хирургия и клиническая анатомия (Пироговский научный журнал) (Russian Journal of Operative Surgery and Clinical Anatomy)

Использование инфографики авторами научных работ

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BACKGROUND

In order to facilitate manipulations in the surgical wound, to reduce surgical risks and complication rate during mini-accesses to the thyroid gland, intraoperative change of the patient’s head position with the optimal angle of view and distance to the surgical target should be taken into account.

OBJECTIVE

To improve the main parameters of the surgical mini-access to the thyroid gland due to the intraoperative polypositioning of the head and neck.

MATERIAL AND METHODS

The material of the study was the data of 50 unfixed cadavers of people of both sexes, who died from various causes not related to thyroid diseases (3—6% of men, 47—94% of women). The age of the deceased varied from 33 to 81 years, the median age was 54 years. In addition, the data of magnetic resonance imaging performed on 100 persons of both sexes — 55 (55%) women and 45 (45%) men — were used in the work. The mean age of the examined persons was 28.48±12.89 years, median — 22 [21; 32] years. The maximum age was 65 years and the minimum age was 18 years. Changes in the angle of view and distance to the surgical target in the position of the body with the neck extended were studied on the cadaver material. Changes in the angle of view and distance to the surgical target, as the most important parameters for assessing the quality of surgical access, were determined by magnetic resonance tomography during flexion and extension of the neck and head rotation.

RESULTS

It was found out that the angle of view and distance to the surgical target depend on the position of the patient’s head and neck. Intraoperative change of the head position was found to change the angle of view and distance to the surgical target. At the stage of treatment of the upper poles of the right and left thyroid lobes, the optimal angle of view is achieved by turning the head to the side contralateral to the operated lobe without additional neck extension. When manipulating the lower parts of the right and left thyroid lobes, the optimal angle of view can be formed by turning the head to the side contralateral to the operated lobe with simultaneous neck extension.

CONCLUSION

The changes of the key parameters of the surgical mini-access to the thyroid gland on the anterior surface of the neck at changing the position of the operated person’s head have been studied and described. This will significantly facilitate the surgical manipulations on the endocrine organs of the neck from this access and expands the data on the positional topography of the organs and anatomical formations of the anterior neck.

Keywords:

thyroid gland

surgery

anatomy

magnetic resonance imaging of neck organs

surgical wound parameters

Authors:

Tatarkin V.V.

I.I. Mechnikov North-Western State Medical University

ORCID: 0000-0002-9599-3935

Trunin E.M.

Mechnikov North-Western State Medical University;
The City Hospital of the Holy Martyr Elizabeth

ORCID: 0000-0002-2452-0321

Dydykin S.S.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-1273-0356

Shchegolev A.I.

Mechnikov North-Western State Medical University;
The City Hospital No 40 of Saint Petersburg

ORCID: 0000-0001-6427-4295

Bakunov A.M.

City hospital of Saint Elizabeth

ORCID: 0000-0003-3389-5026

Vasil'ev Yu.L.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-3541-6068

Chernyshev M.D.

Kirov Military Medical Academy

ORCID: 0009-0008-5483-6328

Shikhalieva K.T.

Mechnikov North-Western State Medical University

ORCID: 0009-0004-0965-5561

Tolgsky M.V.

Mechnikov North-Western State Medical University

ORCID: 0000-0003-2884-0565

Stecik E.O.

Mechnikov North-Western State Medical University

ORCID: 0009-0001-5865-1629

Received:

26.03.2025

Accepted:

14.04.2025

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References:

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