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<p>The Tubercle of Zuckerkandl (TZ) is a critical yet underrecognized anatomical landmark in thyroid and parathyroid surgery. This review synthesizes evidence on its embryology, incidence, morphology, and relationships with the recurrent laryngeal nerve (RLN) and superior parathyroid gland (SPG). Pubmed and Embase databases were systematically searched till May 2025 for studies evaluating incidence and importance of TZ in thyroid surgery. Present in 63–90.5% of thyroid lobes, the TZ is more prevalent on the right and reliably guides RLN (medial/posterior in 83.2–98.4% of cases) and SPG (cranial/posterior, often adhered) identification. Larger TZs correlate with increased transient postoperative hypocalcemia. Recent advances highlight its role in endoscopic and robotic thyroidectomy, while radiological tracing enhances preoperative planning. Awareness of the TZ optimizes safe and complete thyroidectomy, reducing complications and preventing goiter or cancer recurrence. This article advocates for its integration into surgical training, anatomical nomenclature, and preoperative imaging protocols.</p>

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The Tubercle of Zuckerkandl: Unlocking Safer Horizons in Thyroid Surgery

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Bharath Shiva,
  • Abhishek Krishna,
  • Prachi Krishnatrey,
  • Sushobhan Pradhan

摘要

The Tubercle of Zuckerkandl (TZ) is a critical yet underrecognized anatomical landmark in thyroid and parathyroid surgery. This review synthesizes evidence on its embryology, incidence, morphology, and relationships with the recurrent laryngeal nerve (RLN) and superior parathyroid gland (SPG). Pubmed and Embase databases were systematically searched till May 2025 for studies evaluating incidence and importance of TZ in thyroid surgery. Present in 63–90.5% of thyroid lobes, the TZ is more prevalent on the right and reliably guides RLN (medial/posterior in 83.2–98.4% of cases) and SPG (cranial/posterior, often adhered) identification. Larger TZs correlate with increased transient postoperative hypocalcemia. Recent advances highlight its role in endoscopic and robotic thyroidectomy, while radiological tracing enhances preoperative planning. Awareness of the TZ optimizes safe and complete thyroidectomy, reducing complications and preventing goiter or cancer recurrence. This article advocates for its integration into surgical training, anatomical nomenclature, and preoperative imaging protocols.