Division of the lateral thyroid ligament is essential for total thyroi
d lobectomy, The exact extent of this ligament, first described by Ber
ry in 1888, was studied in a series of 25 cadaveric and post-mortem su
bjects. The ligament was attached to the inferior margin of the cornu
of the cricoid cartilage, near its pole, and extended infero-medially
onto the tracheal wall, reaching the midline in 4 of the 50 lobes exam
ined. At the level of the cricoid cartilage, the mean distance between
the attachment of the ligament to the cricoid cartilage and the recur
rent laryngeal nerve (RLN) entry point into the larynx was 1.9 mm, Thi
s region corresponds to the area where RLNs are mostly injured during
thyroid surgery. Awareness of the extent of this ligament and the prox
imity of the RLN to it should lessen the risk of injury to the RLN dur
ing thyroid lobectomy and total thyroidectomy.