Chinese Journal of Clinical Anatomy >
Re-recognization of pretracheal fascia and its clinical significance in thyroid operation
Received date: 2014-04-29
Online published: 2015-04-21
Objective To revisit the pretracheal fascia and the fascial space from the perspective of applied anatomy, and provide the anatomical basis for thyroid surgery. Methods To observe the anatomical features of pretracheal fascia and fascial space through dissection of pretracheal fascia on cadavers and patients with thyroid cancer. Results Pretracheal fascia is divided into two layers, between which structures such as isthmus of thyroid，fat tissues, pretracheal lymph nodes, lymphatic vessels, inferior thyroid vein could be found, assuming a sandwich-like appearance. There is a vessel-free space between the posterior layer of pretracheal fascia and the trachea, called the preteacheal space，which extended downward to the mediastinum, upward to the back of the isthmus and pyramidal lobe，laterally to tracheoesophageal groove. Conclusions Pretracheal fascia is divided into two layers. the integrity of the anterior layer of pretracheal fascia should be maintained when the thyroid and pretracheal fat lymphoid tissues were exposed. Pretracheal space is the surgical plane of dissection for removal of the isthmus，pyramidal lobe of and the pretracheal lymph nodes.
Key words： Pretracheal fascia; Fascial space; Thyroid; Surgery
LEI Chang-Tong , DING Zi-Hai , GE Jun-Na , DIAO Dong-Hui . Re-recognization of pretracheal fascia and its clinical significance in thyroid operation[J]. Chinese Journal of Clinical Anatomy, 2015 , 33(2) : 126 -128 . DOI: 10.13418/j.issn.1001-165x.2015
[1] Williams DW. An image,s guid e to normal neck anatomy
[J]. Semin Ultr asound C T MR, 1997, 18(3):157-181.
[2] Ojiri H, Tada S, Ujita M, et al .Infrahyoidspread of deep neck abcess:anatomical consideration
[J]. Eur Radiol,1998, 8(6):955-959.
[3] Udelsman R, Zhang YW. The epidemic of thyroid cancer in the United States: the role of endocrinologists and ultrasounds
[J].Thyroid, 2014, 24(3):472-479.
[4] Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002
[J]. JAMA, 2006, 295(18):2164-2167.
[5] Morris LG, Sikora AG, Tosteson TD, et al. The increasing incidence of thyroid cancer: the influence of access to care
[J]. Thyroid, 2013, 23(7):885-891.
[6] Enewold LR, Zhou J, Devesa SS, et al. Thyroid cancer incidence among active duty U.S. military personnel,1990-2004
[J]. Cancer Epidemiol Biomarkers Prev, 2011, 20(11):2369-2376.
[7] Zhu C, Zheng T, Kilfoy BA, et al. A birth cohort analysis of the incidence of papillary thyroid cancer in the United States,1973–2004
[J]. Thyroid, 2009, 19(10):1061-1066.
[8] Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer
[J]. Thyroid, 2009, 19(11):1167-1214.
[9] 王怀经， 赵玲辉. 局部解剖学
[M]. 北京:人民卫生出版社，2006: 46-48.
[10]Carty SE, Cooper DS,Doherty GM, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer
[J].Thyroid, 2009,19(11):1153-1159.
[11]Grodski S, Cornford L, Sywak M,et al. Routine level VI lymph node dissection for papillary thyroid cancer: surgical technique
[J]. ANZ J Surg, 2007, 77(4):203-208.
[12]Moo TA, Umunna B, Kato M, et al. Ipsilateral versus bilateral central neck lymph node dissection in papillary thyroid carcinoma
[J].Ann Surg,2009, 250(3):403-408.
[13]Grebe SK, Hay ID. Thyroid cancer nodal metastases: biologic significance and therapeutic considerations
[J]. Surg Oncol Clin N Am,1996, 5(1):43-63.
[14]Scheumann GF, Gimm O, Wegener G, et al. Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer
[J]. World J Surg,1994,18(4):559- 567.
[15]Machens A, Holzhausen HJ, Dralle H. Skip metastases in thyroid cancer leaping the central lymph node compartment
[J]. Arch Surg, 2004,139(1):43-45.
[16]Qubain SW, Nakano S, Baba M, et al. Distribution of lymph node micrometastasis in pN0 well-differentiated thyroid carcinoma
[J]. Surgery, 2002, 131(3):249-256.
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