Modern surgery, general and operative . hers mortahty is per cent. Certain anatomical points are to be bornein mind. The internal jugular vein is frequently found to the inner side ofthe carotid artery and lying on the goiter (because the vein has brancheswhich run to the goiter and hold the vessel against the thyroid). The recur-rent laryngeal nerve ascends along the side of the trachea back of the gland,and is against the esophagus before it passes through the cricothyroid mem-brane. On the right side the nerve is very close to the inferior thyroid arter\,sometimes passing over it, somet
Modern surgery, general and operative . hers mortahty is per cent. Certain anatomical points are to be bornein mind. The internal jugular vein is frequently found to the inner side ofthe carotid artery and lying on the goiter (because the vein has brancheswhich run to the goiter and hold the vessel against the thyroid). The recur-rent laryngeal nerve ascends along the side of the trachea back of the gland,and is against the esophagus before it passes through the cricothyroid mem-brane. On the right side the nerve is very close to the inferior thyroid arter\,sometimes passing over it, sometimes under it. On the left side it is deeperand not so near the artery. The parathyroids are behind the thyroid andusually behind the capsule. In view of the fact that one or both recurrent laryngeal nerves may beparetic from pressure, all cases should be examined with the laryngeal mirrorbefore the operation to determine this point. If the paresis is on one sideonly, the sound vocal cord may possibly compensate by advancing across the. Fig. S06.—Enucleation of cystic goiter; capsuleopened (C. H. Mayo). 1240 Diseases and Injuries of the Thyroid Gland midline. In such conditions the paresis may be first observed followingoperation, leading the operator to think that he has injured a nerve (C. , in Surg., Gyn., and Obst., July, 1907). Intraglandular Enucleation (Socins Operation).—By this operation anadenoma or cyst of the thyroid gland is removed, the encompassing glandulartissue being left in place. The capsule of such a growth is glandular operation of enucleation is not suited to the removal of multiple tumorsand it cannot be performed for parenchymatous goiter or exophthalmic enucleation is performed as follows: The thyroid is exposedby an oblique or by a transverse incision. An incision is made through thecapsule of the thyroid gland and through the glandular tissue until the cystor solid tumor is reached. As a rule, the tumor can
Size: 1536px × 1627px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
