Thyroidectomy - a pictorial walk through the surgical steps
Reviewed by Sangeeta Maini and Bhaskar Ram

We as ENT surgeons work closely with the endocrinologist to provide MDT care for patients with a variety of pathologic conditions of the thyroid gland, including benign, malignant and hormonal disease processes. Surgery plays a central role for a variety of pathologic conditions of the thyroid gland, and knowledge of surgical anatomy is essential. This article is a good read for all clinicians involved in thyroid surgery wanting to learn or revise the key steps. We felt that the key take-home messages in the excellent pictorial walk through the surgical steps were: 1. Steps on identifying minimal manipulation and monitoring the recurrent laryngeal nerve; 2. Guidance on steps to preserve the parathyroid glands by dissecting on the thyroid capsule and reflecting the tissues with the parathyroid glands off the capsule gently with minimal manipulation of the parathyroid glands; 3. Steps on identifying the course of the external branch of the superior laryngeal nerve (EBSLN) during the superior pole dissection using a technique in which the EBSLN is stimulated with the nerve probe; 4. The authors also emphasised the need for special attention to key anatomic areas during the surgery which help the surgeon to avoid leaving residual thyroid tissue behind, particularly in the region of the pyramidal lobe, upper pole, and Berry’s ligament. Overall, we feel that the article is well written and makes a good read for both the less and more experienced surgeons.

Step-by-Step Thyroidectomy—Incision, Nerve Identification, Parathyroid Preservation, and Gland Removal.
Scott B, Wong RJ.
OTOLARYNGOL CLIN NORTH AM
2024;57(1):25-37.