Safety and Effectiveness of Total Thyroidectomy and Its Comparison with Subtotal Thyroidectomy and Other Thyroid Surgeries: A Systematic Review

Diseases associated with the thyroid gland are one of the most frequently seen endocrine disorders across the globe. Total thyroidectomy is currently the preferred treatment for many thyroid diseases. Controversies exist among surgeons regarding safety of total thyroidectomy due to the risk associated with it like postoperative hypoparathyroidism or recurrent laryngeal nerve damage. Since, in the recent years, the incidence of thyroidectomy is in increasing trend in south Indian population, this review aims to study the available data regarding the appropriateness and safety of total thyroidectomy and compares it with subtotal thyroidectomy and other thyroid surgeries. This is a retrospective comprehensive review of various articles and publications regarding total and partial thyroidectomy performed across the world. Many retrospective studies and few prospective studies suggest that the incidence of transient hypocalcemia is higher after total thyroidectomy than after subtotal thyroidectomy, but the incidence of other complications including recurrent laryngeal nerve palsy and postoperative hematoma is not significantly different between the two procedures. Hence in our review we found that total thyroidectomy is safe and cost effective with low complication rates and provides little significant advantage of being safer procedure compared to subtotal thyroidectomy

Atypical course of Maxillary Artery Piercing the Temporalis Muscle in the Infratemporal Fossa

Maxillary artery is one of the important contents of the infratemporal fossa. Reports on branching variations of the maxillary artery in the infratemporal region have been documented in the literature. We report in here a rare case of very superficial course of maxillary artery in the infratemporal fossa. The artery pierced the temporalis muscle from superficial to deep and divided the muscle fibers into superficial anterior and deep posterior parts. Entrapment of the maxillary artery within the muscle fibers may cause numbness or headache and may interfere with the injection of local anesthetics into the infratemporal fossa. Detailed knowledge of variations of maxillary artery in the fossa is of particular relevance in oral maxillofacial surgeries, management of epistaxis, intractable neuralgias or headaches

Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophytes was studied in 40 cadaveric vertebral columns over a period of four years. The lumbar part of the vertebral columns was dissected and examined meticulously. The occurrence of lumbar osteophytes with their vertebral levels and morphometric measurements were recorded. A small excision of the osteophyte was processed histologically to study its microscopic details using routine Haematoxylin & Eosin stain. Results: Lumbar osteophytes were present in 4 specimens (10%). They were mostly found on the right side of the vertebral bodies. Histopathological examination of the osteophytes revealed degenerative osteophytic cartilage and fibrillation overlying the trabecular bone enclosing fatty marrow spaces containing haematopoietic elements. Conclusion: Lumbar osteophytes were found in 10% of the specimens studied and it is assumed that these cadaveric reports deserve further attention given their potential clinical implications. Knowledge regarding occurrence and incidence of osteophytes is essential for management of common degenerative changes of the vertebral column

Y-shaped axillary arch muscle: A case report

The axillary arch is a rudimentary part of the latissimus dorsi. Generally it has a single insertion either into tendon of the pectoralis major, coracobrachialis or fascia over the biceps. Clinically, this anomalous muscular slip is known to cause neurovascular compression of nearby structures. The present case reports an unusual bifurcated fibrous insertion of an axillary arch with Y-shaped limbs. The stem of this muscle was a fleshy belly measuring 7.8 cm. The upper limb of this muscle, measuring 5.6 cm, was attached to the fascia covering the short head of biceps brachii and the coracoid process while its lower limb, measuring 5.1 cm, ended by merging with the brachial fascia over the biceps brachii below the deltoid muscle. The persistence of such a Y-shaped anomalous axillary arch might restrict the hyperabduction of the arm and compress the neurovascular structures passing below it

Rare combined variation of left suprarenal vessels associated with retroaortic left renal vein

Suprarenal vascular variations should be known to surgeons performing laparoscopic adrenalectomy, partial nephrectomy, living donor nephrectomy and renal transplantation. A rare case of vascular variation of the left suprarenal gland was observed, in which the left suprarenal vein was draining into the inferior vena cava after crossing the abdominal aorta anteriorly, just below the origin of the superior mesenteric artery. The left inferior suprarenal artery was originating from the left gonadal artery, which originated from the abdominal aorta in front of the left renal artery. Besides this, the left renal vein passed obliquely downwards behind the abdominal aorta and drained into the inferior vena cava. The retroaortic left renal vein may lead to unilateral hematuria, left varicocele and could be a cause of infertility in men

Safety and Effectiveness of Total Thyroidectomy and Its Comparison with Subtotal Thyroidectomy and Other Thyroid Surgeries: A Systematic Review

Diseases associated with the thyroid gland are one of the most frequently seen endocrine disorders across the globe. Total thyroidectomy is currently the preferred treatment for many thyroid diseases. Controversies exist among surgeons regarding safety of total thyroidectomy due to the risk associated with it like postoperative hypoparathyroidism or recurrent laryngeal nerve damage. Since, in the recent years, the incidence of thyroidectomy is in increasing trend in south Indian population, this review aims to study the available data regarding the appropriateness and safety of total thyroidectomy and compares it with subtotal thyroidectomy and other thyroid surgeries. This is a retrospective comprehensive review of various articles and publications regarding total and partial thyroidectomy performed across the world. Many retrospective studies and few prospective studies suggest that the incidence of transient hypocalcemia is higher after total thyroidectomy than after subtotal thyroidectomy, but the incidence of other complications including recurrent laryngeal nerve palsy and postoperative hematoma is not significantly different between the two procedures. Hence in our review we found that total thyroidectomy is safe and cost effective with low complication rates and provides little significant advantage of being safer procedure compared to subtotal thyroidectomy