Applied anatomic observation of fascia and fascial space surrounding the thyroid gland
LEI Chang-Tong, DING Zi-Hai, LI Guo-Xin
Chinese Journal of Clinical Anatomy ›› 2014, Vol. 32 ›› Issue (4) : 387-391.
Applied anatomic observation of fascia and fascial space surrounding the thyroid gland
Objective Through cadaveric dissection and intra-operative observation, the anatomical features of fascia and fascial space around the thyroid gland was redefined，which in combination with the metastasis path and the region of central compartment lymph node dissection, aims to provide anatomical basis for the dissection of the central compartment lymph nodes and the accurate surgical planes. Methods 5 specimen with 10 sides were fixed in 10% formalin and used to study the fascia, fascial space around the thyroid gland. 10 patients with thyroid cancer are used to define the fascia and fascial space during the operation. Results Pretracheal fascia, sandwich-like in structures, was divided into two layers, the interspace of which had fat tissues, lymph nodes, lymphatic vessels, inferior thyroid vein, et al. There was a vessel-free space between the posterior layer of pretracheal fascia and the trachea, which was perteacheal space. The paratracheal fat tissue was connected to the pretracheal fat tissue and also had a sandwich-like construction with two layers of fascia covering at the front and back, containing vessels, lymphatic system; The anterior and posterior fasciae were in continuation with the carotid sheath on the external surface and were in contact with the thyroid gland on the internal surface, which were similar to the mesentery in structure and function. There was a space between paratracheal fat tissue and thyroid, and between paratracheal fat tissue and prevertebral fascia, respectively. Conclusions The thyroid gland has mesentery which is located in the pretracheal and paratracheal areas. Mesothyroid excision can achieve the purpose of thoroughly removing the lymphoid tissue in the center. Fascial space between mesothyroid and viscera is the surgical plane of the operation.
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