Clinical and anatomical features of blood supply of parathyroid glands: autopsy case series

Abstract

Hypoparathyroidism is the most common complication after surgery on the thyroid gland. All authors confirm the fact that the main cause of hypoparathyroidism is a violation of the blood supply of parathyroid glands, as well as their damage or even accidental removal during surgery. Having analyzed the real cases, and based on our own experience, we came to the conclusion that in order to prevent complications, we will need to study the types of blood supply of the parathyroid glands in details. To this end, we have performed 46 unilateral microdissections and X-ray angiography studies of the arterial supply at 23 organocomplexes of the neck. 42 upper and 43 lower parathyroid glands were detected. It has been established that the main feeding vessel of parathyroid glands is the inferior thyroid artery (type I). The association of glands with the inferior thyroid artery was revealed in 71.8% of cases. A mixed variant of blood supply (simultaneously from the superior and inferior thyroid arteries) was revealed in 14.1% cases (type II). Only 10.6% of the gland were fed isolated from the superior thyroid artery (type III). In addition, in 8.7% cases in the preparations there was no inferior thyroid artery. In 3.5% cases, the connections of the lower parathyroid glands with the thyroid arteries were not reliably detected. Most probably, their feeding was provided at the expense of small collaterals from surrounding organs (type VI).

Keywords

• hypoparathyroidism
• blood supply of parathyroid glands
• prevention of postoperative hypoparathyroidism