Amar D N

Abstract

Background and Objective: Anatomy has been the basis if understanding the structure of the human body to the medical fraternity since the time immemorial and still it continues to do so. Though the medical fields has seen a vast change in the understanding of the diseases and the anatomy of the human body, yet, till date anatomical dissection of the human body is probably the best available method that is available to study in detail and see the first hand information regarding the variations of the structures of the human body without causing any harm to the human race. In the past few years the has been a rise in the number of surgeries that are performed on the thyroid. In today’s day even if the goiter is small, the present day generation remove it soon more for cosmetic reasons as compared to the past when people would not bother even it grew to occupy the entire neck. When we talk about the thyroid, most often importance is paid only to the recurrent laryngeal nerve, but in today’s scenario, in a country like India where litigations are on rise towards the medical fraternity has become the important to understand every single anatomical detail even of the minor structures that were once considered as not so important. The superior laryngeal nerve is one such nerve often referred as the neglected nerve as in thyroidectomy this nerve is not often paid as much attention to as its counterpart the recurrent laryngeal nerve. Identification of this nerve at times can be very difficult and a challenging one to the operating surgeon either because of its displacement as a result of gland enlargemet, or due to the fact. Though this nerve has not been given much clinical importance, the morbidy associated with the injury to this neglected nerve at the time of thyroid surgery can be the reason for a significant morbidity. Paralysis of this neglected nerve can cause a very significant disability, especially to those individuals whose occupation depends on the voice. The well-known legendary opera soprano, Amelita Galli-Curci, this neglected nerve at the time of thyroid surgery which is contributed to end her career as an opera singer. This nerve is one of the less studied or the neglected nerve, in view of this we conducted this study. Keywords: Thyroidectomy, Superior laryngeal nerve, Neglected nerve, Paralysis.

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Abstract

Introduction and Objective: Recurrence is one of the most common complication that occurs following varicose vein surgery and even with the best of the surgeon and techniques followed, recurrences are common. The most common cause for recurrence is the unidentified duplication of the great saphenous vein mistaking the branch of the great saphenous vein that mimics the main vein often when there is an atom equal variation the complete cure cannot be given to patients with varicose veins at least it is possible to postpone the recurrence by adequately treating the varicose veins. The recent trend in the management of varicose veins have change drastically with an increase in the use of minimally invasive techniques like laser, Venus and RFA Most of the anatomical variations occur in the region of sapheno-femoral junction. In view of all the above said we decided to study anatomical variations that are encountered during surgery for varicose veins and their significance in management of varicose veins. Materials and Methods: The study was a non-randomised prospective study that was done on 20 consenting patients format a predefined criteria and posted for varicose vein surgery. The study was conducted during the time period of September 2017 to August 2019 on all consenting patients who made a predefined criteria. Results and Observations: In the present study the mean age was 50.3 years, we had 5 males (40%) and 15 females (60%), left side in 6(30%), bilateral in 4(20%)right side in 10(50%). he most common indication for varicose vein surgery was venous claudication 15(80%). In the present study we had a mean BMI of 20.3kg/m2. Type 1(40%), there was a triangular saphenous compartment containing the gsv and its tributaries. Type 2(10%), there was a fascial canal that contained gvs. Type 3(50%), there was a small fascial saphenous compartment with variable boundaries that contained the great saphenous vein and 1 or 2 of Keywords: Varicose veins, Great saphenous vein. Anatomy.

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