The anatomical basis for preserving the blood supply to the parathyroids during thyroid surgery, and a review of current technologic advances.

Background: Devascularization of the parathyroid glands is generally accepted as the most common mechanism for iatrogenic hypocalcemia, a frequently seen complication of both total and completion thyroidectomy procedures. Much has been written about iatrogenic hypoparathyroidism, but few papers have precisely delineated the arterial supply of the parathyroid glands and the common anatomical variations that may impact parathyroid preservation during thyroid surgery.

Methods: We offer an illustrated review and discussion of the only two anatomic studies published in the medical literature focusing on parathyroid vasculature.

The Prevalence of Extranodal Extension in Papillary Thyroid Cancer Based on the Size of the Metastatic Node: Adverse Histologic Features Are Not Limited to Larger Lymph Nodes.

Extranodal extension (ENE) is a prognostic indicator of aggressiveness for papillary thyroid cancer (PTC). The association between the size of metastatic nodes and the prevalence of ENE has not been previously explored. However, there is a common belief that small lymph nodes with metastatic disease do not significantly impact patient outcome.

Pathologic Reporting of Tall-Cell Variant of Papillary Thyroid Cancer: Have We Reached a Consensus?

Background: Tall-cell variant (TCV) is widely believed to be a more aggressive subtype of papillary thyroid carcinoma (PTC). Despite the significance of TCV with respect to risk stratification and therapeutic decision making, its diagnosis is subject to inter-observer variability. This study aimed to determine the level of agreement among expert pathologists in the identification and reporting of TCV.

Intermittent facial spasms as the presenting sign of a recurrent pleomorphic adenoma.

The intimate anatomical relationship of the facial nerve to the parotid parenchyma has a significant influence on the presenting signs and symptoms, diagnosis and treatment of parotid neoplasms. However, to our knowledge, hyperactivity of this nerve, presenting as facial spasm, has never been described as the presenting sign or symptom of a parotid malignancy. We report a case of carcinoma arising in a recurrent pleomorphic adenoma of the left parotid gland (.

The importance of recognizing a cervical origin of the right subclavian artery.

Cervical origin of the right subclavian artery is rare and is associated with DiGeorge syndrome. During total thyroidectomy and right lateral neck dissection for metastatic thyroid cancer in a 26-year-old female, the right subclavian artery was found to be cervical in origin. This was identifiable on preoperative computerized tomography.

Influence of previous treatment of oral squamous cell carcinoma on the geographic distribution of recurrent neck metastases: A case series of unusual level 4 metastases.

Background: Cervical node management is vital for the successful treatment of oral squamous cell carcinoma (OSCC). Lymphatic spread from intra-oral malignancies usually follows a predictable path. We report on two patients with isolated level 4 recurrence following previous treatment for OSCC.