Tubérculo de Zuckerkandl. Situación, forma y dimensiones / Zuckerkandl's tubercle. Location, shape and dimensions

Introducción y objetivo: Aunque no es conocido por buena parte de los cirujanos de cabeza y cuello, el tubérculo de Zuckerkandl es un detalle anatomoquirúrgico fundamental, descrito ya en el siglo XIX; su detección tiene gran importancia al servir de referencia en la búsqueda del nervio recurrente y de la glándula paratiroides superior. Material y método: Diseñamos un estudio descriptivo prospectivo para analizar el borde posterolateral de los lóbulos tiroideos buscando esta formación. Incluimos 107 tiroidectomías realizadas por un mismo cirujano, 88 son tiroidectomías totales (82,24%) y 19 hemitiroidectomías (17,75%); con lo que se disecaron 195 lóbulos tiroideos. El tubérculo de Zuckerkandl debe buscarse luxando hacia fuera el borde posterolateral de los lóbulos tiroideos. Resultados: Se detecta con seguridad en 155 lóbulos tiroideos (79,48%). El tubérculo tiene unas dimensiones medias de 11 mm de eje transversal, 9 mm de eje longitudinal. La forma del tubérculo de Zuckerkandl es sesil (70,96%) o pediculada (29,03%). En el 5,80% de los casos el extremo distal del tubérculo de Zuckerkandl es bífido. No encontramos un tubérculo de Zuckerkandl individualizado a modo de tiroides ectópico (0,00%). El tubérculo de Zuckerkandl es más frecuente en el lóbulo tiroideo derecho (p=0,06). Conclusión: El tubérculo de Zuckerkandl se reconoce por su situación, forma y dimensiones(AU)

Introduction and objective: Although Zuckerkandl's tubercle is not known by many head and neck surgeons, it is a fundamental surgical anatomical detail, already described in the nineteenth century. Its detection is of great importance as the reference in the search for the recurrent nerve and superior parathyroid gland. Material and method: We designed a prospective study to analyse the posterolateral border of thyroid lobes, looking for this tubercle. We included 107 thyroidectomies performed by the same surgeon; 88 were total thyroidectomies (82.24%) and 19 hemithyroidectomies (17.75%), with dissection of a total of 195 thyroid lobes. Zuckerkandl's tubercle should be sought by displacing the posterolateral margin of the thyroid lobes. Results: It was reliably detected in 155 thyroid lobes (79.48%). The mean tubercle dimensions were 11 mm transverse axis and 9 mm longitudinal axis. The shape of the Zuckerkandl's tubercle was sessile (70.96%) or pedunculated (29.03%). In the 5.80% of cases, the Zuckerkandl's tubercle distal end was bifid. We did not find a Zuckerkandl's tubercle individualised as an ectopic thyroid (0.00%). Zuckerkandl's tubercle was more frequent in the right thyroid lobe (P=.06). Conclusion: Zuckerkandl's tubercle is recognised by its location, shape and dimensions(AU)

[Zuckerkandl's tubercle. Location, shape and dimensions]. / Tubérculo de Zuckerkandl. Situación, forma y dimensiones.

INTRODUCTION AND OBJECTIVE: Although Zuckerkandl's tubercle is not known by many head and neck surgeons, it is a fundamental surgical anatomical detail, already described in the nineteenth century. Its detection is of great importance as the reference in the search for the recurrent nerve and superior parathyroid gland. MATERIAL AND METHOD: We designed a prospective study to analyse the posterolateral border of thyroid lobes, looking for this tubercle. We included 107 thyroidectomies performed by the same surgeon; 88 were total thyroidectomies (82.24%) and 19 hemithyroidectomies (17.75%), with dissection of a total of 195 thyroid lobes. Zuckerkandl's tubercle should be sought by displacing the posterolateral margin of the thyroid lobes. RESULTS: It was reliably detected in 155 thyroid lobes (79.48%). The mean tubercle dimensions were 11 mm transverse axis and 9 mm longitudinal axis. The shape of the Zuckerkandl's tubercle was sessile (70.96%) or pedunculated (29.03%). In the 5.80% of cases, the Zuckerkandl's tubercle distal end was bifid. We did not find a Zuckerkandl's tubercle individualised as an ectopic thyroid (0.00%). Zuckerkandl's tubercle was more frequent in the right thyroid lobe (P=.06). CONCLUSION: Zuckerkandl's tubercle is recognised by its location, shape and dimensions.

[The avian middle ear (Struthio camelus). Data for the physiology of sound transmission in systems with a single ossicle in the chain]. / Del oído medio de las aves (Struthio camelus). Datos para la fisiología de la transmisión en sistemas de un único osículo en la cadena.

INTRODUCTION AND GOALS: The columella of birds, often cited in the literature, has yet to be adequately described. We aim to give an account of this transmission element, describing its anchoring systems and detailing the muscle associated to it. MATERIAL AND METHOD: We performed microscopic dissection and obtained images of ostrich specimens (Struthio camelus), chosen because it is the bird with the largest head. RESULTS: We describe the columella: the osseous tripod formed on its external section (extracolumella), the conic shape of its inner section (stapedial), and links to the tympanic membrane and the oval window. We describe its anchoring system: posterior ligament and annular ligament. We conclude by describing the characteristics of the columella muscle, its insertions and the fibrous vein surrounding it. CONCLUSIONS: The avian middle ear is a valid model for understanding the mechanical characteristics of the human ear repaired with total ossicular replacement prosthesis, ie replacement of the ossicular chain by a single element. We highlight an apparent contradiction: the existing muscle is inserted into the columella in an area close to the tympanic membrane rather than adjacent to the oval window.

Del oído medio de las aves (Struthio camelus). Datos para la fisiología de la transmisión en sistemas de un único osículo en la cadena / The avian middle ear (Struthio camelus). Data for the physiology of sound transmission in systems with a single ossicle in the Chain

Introducción y objetivos: La columela de las aves, citada frecuentemente en la literatura, no aparece descrita convenientemente. Pretendemos mostrar este elemento de transmisión sonora precisando sus sistemas de anclaje y fijación y detallando el músculo de que dispone. Material y método: Realizamos una disección microscópica de especímenes de avestruz (Struthio camelus), y obtuvimos y procesamos imágenes de éstos. Escogimos este animal por ser el ave con mayor tamaño cefálico. Resultados: Se describe la columela: el trípode óseo que se forma en su porción externa (extracolumela), la forma cónica de su porción interna (estapedial), sus relaciones con la membrana timpánica y con la ventana oval. Mostramos sus medios de anclaje: ligamento posterior y ligamento anular. Relatamos las características del músculo de la columela, sus inserciones y la potente vaina fibrosa que lo rodea. Conclusiones: El oído medio de las aves es un modelo válido para la comprensión de las características mecánicas del oído humano, en el que se sustituye la cadena osicular por un solo elemento de transmisión sonora. Denotamos una aparente paradoja: el músculo existente se inserta en la columela en un lugar próximo a la membrana timpánica, en vez de en la proximidad de la ventana oval

Introduction and goals: The columella of birds, often cited in the literature, has yet to be adequately described. We aim to give an account of this transmission element, describing its anchoring systems and detailing the muscle associated to it. Material and method: We performed microscopic dissection and obtained images of ostrich specimens (Struthio camelus), chosen because it is the bird with the largest head. Results: We describe the columella: the osseous tripod formed on its external section (extracolumella), the conic shape of its inner section (stapedial), and links to the tympanic membrane and the oval window. We describe its anchoring system: posterior ligament and annular ligament. We conclude by describing the characteristics of the columella muscle, its insertions and the fibrous vein surrounding it. Conclusions: The avian middle ear is a valid model for understanding the mechanical characteristics of the human ear repaired with total ossicular replacement prosthesis, ie replacement of the ossicular chain by a single element. We highlight an apparent contradiction: the existing muscle is inserted into the columella in an area close to the tympanic membrane rather than adjacent to the oval window