Zuckerkandl Tubercle: An Important Landmark in Thyroid Surgery.

OBJECTIVE To find out the frequency of Zuckerkandl Tubercle (ZT) and the position of recurrent laryngeal nerve with reference to ZK. STUDY DESIGN Cross-sectional observational study. PLACE AND DURATION OF STUDY Surgical Ward-3, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from June 2010 to August 2011. METHODOLOGY Patients having goiter, aged between 12 - 60 years were admitted through OPD and operated after informed written consent. After admission, they underwent surgery. ZT and recurrent laryngeal nerve position i.e. whether medial, lateral or posterior to ZT was identified during surgery. Data was collected on pre-designed proforma and analysed on SPSS version 15 for descriptive statistics. RESULTS Out of the 84 patients ZT was found in 52 (61.90%) patients. Nineteen patients had grade-I (less than 0.5 cm), 22 (42.3%) had grade-II (0.5 - 1 cm) and 11 (21.1%) had grade-III (more than 1 cm) ZT. During surgery, 33 (63.4%) patients had recurrent laryngeal nerve medial to ZT, 15 (28.8%) patients had lateral and in 4 (7.6%) patients recurrent laryngeal nerve was engraved posteriorly. CONCLUSION Zuckerkandl tubercle was found in about 62% cases; recurrent laryngeal nerve was located pre-dominantly medial to ZT.