The tubercle of Zuckerkandl, the ligament of Berry – importance for thyroid surgery

The anatomical structures of the tubercle of Zuckerkandl (TZ) and the ligament of Berry (LB) have been known since the turn of the 20th century. The importance of the relationship between these structures and the thyroid gland was pointed out in the first half of the last century; nevertheless, it was neglected by most of the then surgeons. An increased interest of surgeons in detailed knowledge of these structures could only be observed from the 80´s of the last century in connection with guidelines for radical surgical treatments of the gland (both for benign and malignant diseases) and with the need to enhance the safety of these treatments. The knowledge of these two important structures and the skill of an exact surgical technique are necessary for the protection of the recurrent laryngeal nerve and the parathyroid glands, and also for the actual removal of the entire thyroid gland. Thyroid surgeons must keep in mind the existence of many anatomical and pathological variations in these regions, which makes the preparation of the gland so delicate.