Zuckerkandl’s tubercle and its relationship to the recurrent laryngeal nerve: A cadaveric dissection and meta-analysis

Publication date: Available online 2 April 2017
Source:Auris Nasus Larynx
Author(s): Brandon Michael Henry, Beatrice Sanna, Jens Vikse, Matthew J. Graves, Alexandru Spulber, Cecylia Witkowski, Iwona M. Tomaszewska, R. Shane Tubbs, Krzysztof A. Tomaszewski
ObjectiveZuckerkandl's tubercle (ZT), when present, is an anatomical landmark by which surrounding structures such as the recurrent laryngeal nerve (RLN) can be identified intraoperatively. This study aimed to investigate the prevalence and anatomical characteristics of Zuckerkandl's tubercle by combining cadaveric dissection with a meta-analysis.MethodsThrough October 2016, an extensive search of PubMed, CNKI, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science was completed. Extracted data, along with the findings from our cadaveric dissections, were pooled into a meta-analysis to assess the prevalence and size of ZT and its relationship to the RLN.ResultsThe pooled prevalence estimate of a ZT was 70.2% in the general population, 65.0% of which were considered Grade 0 tubercles (<1.0cm) and 35.0% Grade 1 (≥1.0cm). The RLN ran posteromedially to the ZT in 82.7% of cases, laterally to it in 8.7%, and on top of it in 8.6% of hemilarynges.ConclusionRLN palsy is a common postoperative complication and cause for litigation following neck surgery. The ZT is a common component of the thyroid gland and with proper knowledge, surgeons can use it to reliably and quickly identify the RLN during operative procedures.



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