SURGICAL TECHNIQUES IN THYROID OPERATIONS

The thin fascial layer covering the vessels of the throat and the recu rrent laryngeal nerve represents an essential structure in thyroid sur gery. For protecting the parathyroid artery and the recurrent laryngea l nerve this fascia must be dissected away from the thyroid capsula pr opria. Incomplete dorsal dissection may leave dorsal nodes leading to recurrent goiter or recurrent autonomy, whereas penetrating the fascia may injure the recurrent laryngeal nerve and the parathyroid glands. This various handling of the covering fascia can be traced from Billro th and Kocher until today. It determines also whether the recurrent la ryngeal nerve is dissected free early and completely during thyroidect omy or whether it is only located behind the fascia or through a small window.