Abstract

Aim of study: The aim of the study is to investigate the frequency of parathyroid gland variations, especially location, shape and number variation during thyroidectomy.

Materials and methods: The study involved a number of 137 patients, who underwent thyroidectomy between January 2010-January 2013. Parathyroid glands are studied for determining anatomical variations, especially location variations, shape and number.

Results: A number of 452 parathyroid glands were identified. The anatomical norm of number was 4gl/ps found in 62% of patients. Number variations resulted from 2, 3 and 5gl/ps. Most parathyroid glands were found in oval/beanlike shape in 54% of cases. Other shape variations were found in 46%. Ectopy was found in 8.2% of glands, of them superior parathyroids were ectopic in 6% of cases, inferior parathyroids in 9.6% of them. Variation in location was found approximately in 13.7% for superior parathyroids and 41.7% in inferior parathyroids.

Discussion: Anatomical knowledge, identification and preservation of glands are necessary for a secure and successful thyroid and parathyroid gland surgery. This study shows that despite the wide distribution, the normal parathyroid glands falls into a definite pattern, and can be uncovered in these locations in the majority of cases.

Conclusions: Anatomical knowledge of parathyroid anatomy and its variations is essential in thyroid and parathyroid surgery in order to minimize the rate of thyroid surgery morbidity, especially lesions of parathyroid glands, their iatrogenic excision and laryngeal nerves damage.

Keywords: Parathyroids; Orthotopy; Ectopy; Variations

Abbreviations: ITA: Inferior Thyroid Artery; Gls: Glands; HPT1: Primary Hyperparathyroidism; HPT2: Secondary Hyperparathyroidism; LL: Left Lobectomy; MNG: Multinodular Goiter; M Basedov: Morbus Bazedov; PGs: Parathyroid Glands; PIII: Inferior Parathyroid Glands; PIV: Superior Parathyroid Glands; Pts: Parathyroids; PHPT: Primary Hyperparathyroidism; RLN: Recurrent Laryngeal Nerve; RL: Right Lobectomy; ST: Subtotal Thyroidectomy; TT: Total Thyroidectomy; TG: Thyroid Gland; TZ: Tuberculum of Zuckerkandle; UPG: Undescended Parathyroid Glands