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OPERATIVE TECHNIQUE FOR THYROIDECTOMY Under general endotracheal anesthesia, the patient is placed in a supine position with the neck extended. A low collar incision is made and carried down through the subcutaneous tissue and platysma muscle (Fig. 15A). Currently, small incisions are the rule unless a goiter is present. Superior and inferior subplatysmal flaps are developed, and the strap muscles are divided vertically in the midline and retracted laterally (Fig. 15B). Figure 15. A , Incision for thyroidectomy. The neck is extended and a symmetrical, gently curved incision is made 1 to 2 cm above the clavicle. In recent years the author has used a much smaller
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Unformatted text preview: incision except when a large goiter is present; B , The sternohyoid and sternothyroid muscles are retracted to expose the surface of the thyroid lobe; C , The surgeon’s hand retracts the gland anteriorly and medially to expose the posterior surfaces of the thyroid gland. The middle thyroid vein is identified, ligated and divided; D, The superior thyroid vessels are ligated on the thyroid capsule of the superior pole to avoid inadvertent injury to the external branch of the superior laryngeal nerve. This nerve can be seen in many cases...
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