Year 2016 Vol. 24 No 1

GENERAL & SPECIAL SURGERY

A.V. CHERNYKH, Y.V. MALEEV, E.F. CHEREDNIKOV, A.N. SHEVTSOV, D.N. GOLOVANOV

NEW DATA ON SURGICAL ANATOMY OF PARATHYROID GLANDS

SBEE HPE "N.N. Burdenko Voronezh State Medical University"
The Russian Federation

Objectives. To develop new approaches to the assessment of surgical anatomy of the parathyroid glands and to obtain new data permitted to improve the quality of planning and performance of operations on the organs of the neck, to reduce the risk of diagnostic errors and development of intraoperative and postoperative complications.
Methods. The study was performed on cadavers (152 men; average age – 47,0±1,0 years) and (68 women; 51,3±1,9 years). Before an autopsy of each cadaver the anthropometric measurements of the neck were done. The width, length of the axis, thickness and height of the parathyroid glands had been measured on the neck organocomplexes extracted from the corpses. The parameters characterized the position of the parathyroid glands towards to the thyroid gland in different planes were proposed.
Results. Totally 1033 parathyroid glands were visualized. More than half of the cases (54,0%) the number of glands exceeded 4. The length of the axis of the parathyroid glands was greater than 1,0 cm in 10,5% of cases. The analysis of age-related changes of linear dimensions and volume of glands allowed identifying three main periods in the postnatal ontogenesis of the glands. It was revealed that 95,4% of glands had typical location in relation to the height of thyroid lobes. The glands located above the upper pole of thyroid lobe were the most distant from the midline, the gland located below the lower pole of the thyroid gland - the most approximate. The angle of axis inclination of parathyroid glands to the median line in the frontal plane and the distance from the glands to the back surface of the thyroid lobe depends on the level of the parathyroid glands localization in relation to the height of thyroid lobe.
Conclusion. Practical implementation of the proposed criteria permits to perform preoperative prediction of topography of the parathyroid glands and their accurate intraoperative visualization, improving the quality of operations performed on the thyroid and parathyroid glands.

Keywords: parathyroid glands, thyroid gland, surgical anatomy, topography, linear dimensions, intraoperative visualization, incisional complication
p. 26-31 of the original issue
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Address for correspondence:
394036, Russian Federation,
Voronezh, ul. Studencheskaya, d.10,
GBOU VPO ''Voronezhskiy gosudarstvennyiy
meditsinskiy universitet im. N.N. Burdenko'',
kafedra operativnoy khirurgii s topograficheskoy anatomiey,
tel. office: 7 (473) 253-10-70,
e-mail: shan-87@yandex.ru,
Shevtsov Artem Nikolaevich
Information about the authors:
Chernykh A.V. MD, professor, a head of the operative surgery chair with topographic anatomy of SBEE HPE "N.N.Burdenko Voronezh State Medical University", the first Vice-rector of SBEE HPE "N.N.Burdenko Voronezh State Medical University".
Maleev Y.V. MD, an associate professor of the operative surgery chair with topographic anatomy of SBEE HPE "N.N.Burdenko Voronezh State Medical University".
Cherednikov E.F. MD, professor, a head of the faculty surgery chair of SBEE HPE " N.N.Burdenko Voronezh State Medical University".
Shevtsov A.N. PhD, an assistant of the operative surgery chair with topographic anatomy of SBEE HPE "N.N.Burdenko Voronezh State Medical University".
Golovanov D.N. An extramural post-graduate student of the operative surgery chair with topographic anatomy of SBEE HPE "N.N.Burdenko Voronezh State Medical University".
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