The tubercle of Zuckerkandl, the ligament of Berry –
importance for thyroid surgery

Česká verzia

Authors: J. Dvořák ; M. Šnajdr; D. Šmrhová
Authors place of work: Chirurgické oddělení Karlovarské krajské nemocnice, Karlovy Vary
Published in the journal: Rozhl. Chir., 2021, roč. 100, č. 3, s. 105-109.
Category: Review
doi: https://doi.org/10.33699/PIS.2021.100.3.105–109

Summary

The anatomical structures of the tubercle of Zuckerkandl (TZ) and the ligament of Berry (LB) have been known since the turn of the 20^th century. The importance of the relationship between these structures and the thyroid gland was pointed out in the first half of the last century; nevertheless, it was neglected by most of the then surgeons. An increased interest of surgeons in detailed knowledge of these structures could only be observed from the 80´s of the last century in connection with guidelines for radical surgical treatments of the gland (both for benign and malignant diseases) and with the need to enhance the safety of these treatments. The knowledge of these two important structures and the skill of an exact surgical technique are necessary for the protection of the recurrent laryngeal nerve and the parathyroid glands, and also for the actual removal of the entire thyroid gland. Thyroid surgeons must keep in mind the existence of many anatomical and pathological variations in these regions, which makes the preparation of the gland so delicate.

Keywords:

Tuberculum Zuckerkandli − ligamentum Berry

Zdroje

Mirilas P, Skandalakis JE. Zuckerkandl´s tubercle: Hannibal ad portas thyroid gland: In Greenfield LJ, Mullholland MW, Oldham KT eds. Surgery: scientific principles and practice 2. Lipppincott-Raven, Philadelphia 1997.
Leow CK, Webb AJ. The lateral thyroid ligament of Berry. Int Surg. 1998;83(1):75−78.
Firkin BG, Whitworth JA. Dictionary of medical eponyms. The Parthenon Publishing Group New Jersey 1989:41:591.
Dvořák J, Dudešek B. Štítná žláza. Chirurgická anatomie a operační technika. Praha, Serifa 2015, ISBN 80-902859-0-2.
Nahodil V, et al. Chirurgie štítné žlázy. Praha, Avicenum 1988.
Holland PA, Thomas WEG. Thyroidectomy and its complications. Surg International 1999;44:7−10.
Astl J. Chirurgická léčba nemocí štítné žlázy. Jesenius Maxdorf 2014.
Zuckerkandl E. Nebst Bermerkungen uber die Epithelkorperchen des Menschen. Anat Hefte 1902:I.XI:61.
Gauger PG, Delbridge LW, Thompson NW, et al. Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery. Eur J Surg. 167(4):249−54. doi. 10.1080/110241501300091363.
Gil-Carcedo Sañudo E, Menéndez Argüelles ME, Vallejo Valdezate LÁ, et al. Tubérculo de Zuckerkandl. Situacion, forma y dimensiones. Acta Otorrhinolaryngologica Espaňola 2012;63(6):443−449.
Mehanna R, Murphy MS, Sheahan P. Thyroid tubercle of Zuckerkandl is more consistently present and larger on the right: A prospective series. Eur Thyroid J. 2014 Mar;3(1):38–42. doi: 10.1159/000355823.
Pelizzo MR, Toniato A, Gemo G, et al. Zuckerkandl´s tuberculum: An arrow pointing to the recurrent laryngeal nerve (constant anatomical landmark). Am J Coll Surg. 1998:(187)3:333−336. doi: 0.1016/s1072-7515(98)00160-4.
Mansberger AR, Wei JP. Surgical embryology and anatomy of the thyroid and parathyroid glands. Surg Clin North Am. 1993:73:727−746.
Kocak S, Aydintug S. Zuckerkandl´s tuberculum. Letters to the editor. Am J Coll Surg. 2000:190(1):98−99.
Dvořák J, Kubín S, Dyrc D. Nervus laryngeus non-recurrens. Rozhl Chir. 2004;83(2):62−66.
Gilmour JR. The gross anatomy of the parathyroid glands. J Patol. 1938:46:133−149. doi: 10.1002/path. 1700460113.
Hisham AN, Aina EN. Zuckerkandl´s tubercle of the thyroid gland in association with the pressure symptoms: a coincidence or consequence? ANZ J Surg. 2000;70:251−253.doi: 10.1046/j.1440-1622. 2000.01800.x.
Wang C. The use of the inferior cornu of the thyroid cartilage in identifying the recurrent laryngeal nerve. Minerva chirurgica 1993;48:189−191.
Berry J. Suspensory ligaments of the thyroid gland. J Anat Physiol. 1888;22:4−5.
Sasou S, Nakamura S, Kurihara H. Suspensory ligament of Berry: Its relationship to recurrent laryngeal nerve and anatomic examination of 24 autopsies. Head and Neck 1998;695−698. doi: 10.1002/(sici)1097-0347(199812)20:8<695::aid-hed6>3.0.co;2-3.
Salama AB, McGrath P. Recurrent laryngeal nerve and the posterior fascial attachement of the thyroid gland. Aust N Z J Surg. 1992;62:444−449. doi: 10.1111/j.1445-2197.1992.tb07224.x.
Berlin DD. The recurrent laryngeal nerves in total ablation of the normal thyroid gland. An anatomical and surgical study. Surg Gyn Obst. 1935;60:16−19.
Yang S, Zhou L, Lu Z, et al. Systematic review with metaanalysis of intraoperative neuromonitoring during thyroidectomy. Int J Surg. 2017;39:104−113. doi: 10.1016/j.ijsu.2017.01.086.
Stopa M, Barczynski M. Prognostic value of intraoperative neural monitoring of the recurrent laryngeal nerve in thyroid surgery. Langenbecks Arch Surg. 2017:402(6):957−964. doi:10.1007/s00423 -016-1441-0.