The muscle parts attaching to the
thyroid cartilage were incised to expose the lamina of the cartilage and TF clearly.
An injection needle (1.1 x 40 mm, 21# Sterican Hypodermic Needle; Braun Melsungen AG, Melsungen, Germany) is used to mark a point [C in [Figure 1] on the thyroid lamina 2 mm at least anterior to the reference point [B in [Figure 1] and 5 mm superior to the inferior margin of the
thyroid cartilage in men and 4 mm in women.
Then, we proceeded to the external approach, and
thyroid cartilage window with a Skeeter drill window of 12 mm [2] was made and the foreign body was retrieved (Figures 2 and 3).
(2006) performed a study on 36 cadavers, and found that the CCA bifurcated at the level of the body of the hyoid bone in 15 (88.9%), at the superior border of
thyroid cartilage in 11 (42.3%), and at the tip of the greater horn of hyoid bone in 8 (15%) cadavers.
During thyroid surgery two possible sites of tracheal injury exist: at the isthmus, when the thyroid is separated from the trachea, and at the area where the recurrent laryngeal nerve enters the
thyroid cartilage during lateral and posterior dissection [13].
After the sternocleidomastoid muscle and the strap muscle were identified, we cut through the linea alba cervicalis incision with a harmonic scalpel between the strap muscles from the suprasternal notch to
thyroid cartilage. The general principle of surgical procedures for robotic total thyroidectomy was the same as conventional open thyroidectomy.
A post mortem examination by a Home Office pathologist concluded the victim died from injuries consistent with a ligature compression of the neck, including fractures of the
thyroid cartilage.
Particular findings include horizontal
thyroid cartilage fractures (Figure 1), fractures of the superior thyroid cornua as well as hyoid fractures (Figure 2), malalignment and malposition injuries.
Eventually, each recurrent laryngeal nerve enters the larynx between the inferior cornu of the
thyroid cartilage and the arch of the cricoid, branching after laryngeal penetration in two-thirds of cases.