The second patient undergoes a similar dissection as was seen in the previous patient (note the patient’s head is oriented toward the bottom of the screen). The trachea is exposed and the thyroid glands are both visualized and carefully inspected. A bulge seen in the caudal aspect of the thyroid gland is most likely the parathyroid mass causing this patient’s hypercalcemia. In this particular case, the surgeon elected to remove both the parathyroid and thyroid glands because the tumor was buried within the central portion of the thyroid tissue, and careful dissection likely would not be successful in removing all of the parathyroid tissue. Once the cranial thyroid artery is identified, bipolar cautery is used for hemostasis. On inspection of the opposite side, the cranial pole of the thyroid gland was felt to be possibly enlarged as well. The surgeon elected to biopsy the area to determine if the parathyroid gland was adenomatous or normal tissue. In this case, the tissue was confirmed to be normal parathyroid tissue.
Closure is routine, closing the sternohyoideus-thyroideus muscles, the subcutaneous tissue, and then the skin.