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Introduction: During thyroid surgery identification of Recurrent laryngeal nerve (RLN) is an esse... more Introduction: During thyroid surgery identification of Recurrent laryngeal nerve (RLN) is an essential step,as any injury to it will lead to hoarseness or loss of voice. Tubercle of zuckerkandl (TZ), a projection from the postero-lateral aspect of throid lobe, is a useful landmark in the identification of RLN which usually runs in its vicinity. Aim & Objective: The aim of this study is to demonstrate the effectiveness of RLN identification using the ZT as an anatomical landmark in comparison with the usual infer superior dissection of the tracheoesophageal groove. Study Design: A prospective comparitive study was carried on two groups of patients who underwent total thyroidectomy for multinodular goitre at general surgery department, narayana medical college, nellore.In one group RLN was identified by taking TZ as landmark and in other group RLN was identified with inferosuperior dissection of tracheooesophageal groove during thyroidectomy. Post operatively RLN integrity was recorded by vocal cord examination and both groups compared. Results: A total of 70 patients underwent total thyroidectomy, 21 females and 49 males. 38 underwent RLN identification using TZ as landmark (group A) and 32 underwent RLN identification by trcheooesophageal groove dissection (group B). The mean age of patients in both groups was equal. the incidence of RLN injury in group B was higher than in group A with statistically significant numbers. Conclusion: The findings of our study confirm that using TZ as landmark for identification of RLN is associated with low risk of injury to the latter thus enabling safe thyroid surgery.

Journal of clinical and diagnostic research : JCDR, 2017

An eight-year-old girl child reported to the Department of Oral Medicine and Radiology with the c... more An eight-year-old girl child reported to the Department of Oral Medicine and Radiology with the chief complaint of unerupted permanent teeth for past two years. The child presented features like disproportionately short stature, rhizomelic shortening of arms and legs, long face, frontal bossing and saddle nose. Based on the findings of chest and spine radiographs and ultrasound the case was diagnosed as a rare bone disorder "Achondroplasia". This case also presents a unique feature of polydactyly. Polydactyly is a manifestation in clinical medicine because it can serve as an indicator for a plethora of congenital anamolies. This case gained dental interest because of its characteristic craniofacial features. This article highlights the peculiar manifestations of this anamoly.

Lingual thyroid is a rare developmental anomaly resulting from the failure of the thyroid to desc... more Lingual thyroid is a rare developmental anomaly resulting from the failure of the thyroid to descend from the foramen caecum to its prelaryngeal site. The ectopic gland located at the base of the tongue is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia, upper airway obstruction and hemorrhage, often with hypothyroidism. Treatment of this disorder includes the use of exogenous thyroid hormone to correct the hypothyroidism and to induce shrinkage of the gland. However, ablative therapy by means of surgery or radioiodine is necessary when symptoms of obstruction or bleeding appear. In the current case report we present a case of lingual thyroid occurring in a 10 years old female patient.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017