Thyroidectomy Flashcards
What are the causes for Thyroidectomy?
- Progressive Goiters
- Thyroid Cancer
What is Patient Positioning for a Thyroidectomy?
- Supine with bilateral arms tucked
- Neck extended
- Shoulder roll under Scapula
- Head in ring pillow
- Head of bed tilted down
What special equipment is used for Thyroidectomies?
- Harmonic Scalpel
- Nerve Integrity Monitoring System (NIMs)
What is the NIMs used for during Thyroidectomies?
To protect the Recurrent Laryngeal Nerves
Where is the skin incision made for a Thyroidectomy?
Midway between the Cricoid and Sternal Notch (in a Langer Line if possible)
What is done after making the skin incision during a Thyroidectomy?
- Lifting of Platysma Flap
- Separate Strap Muscles at midline
- Begin Thyroid dissection
What are the four Strap Muscles?
Infrahyoid Muscles
- Thyrohyoid
- Omohyoid
- Sternohyoid
- Sternothyroid
Why is ligation of the Thyroid vessels important?
To prevent a Hematoma
-Hematoma of the anterior neck can depress the Trachea and close the airway
What structures are important to identify during a Thyroidectomy?
- Recurrent Laryngeal Nerves
- Parathyroid Glands
What is the first step after removal of the Thyroid?
Closure of Sternothyroid muscles at midline
3-0 Vicryl on an SH needle
What is done after closing the Sternothyroid muscles?
Closure of Platysma muscle flap
3-0 Vicryl on an SH needle
What is done after closing the Platysma muscle flap?
Closure of skin
4-0 Monocryl on a PS2 needle
What are the dressings for a Thyroidectomy?
- Mastisol
- Steristrips
- Queen Anne’s dressing
Why must you not use Dermabond on a Thyroidectomy skin closure?
It seals the wound and doesn’t allow pressure to escape in case of a Hematoma
What is the Queen Anne’s Dressing technique?
Fluffed up 4x4’s with a towel crossed around the neck (apply pressure to neck without compressing Trachea)
