Published online: 2020-04-22
NUJHS Vol. 5, No.1, M arch 2015, ISSN 2249-7110
Nitte University J ournal of Health Science
Case Report
VARIATION IN THE STRUCTURE OF LEVATOR GLANDULAE
THYROIDEA – A CASE REPORT
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Raghavendra A Y , Vishal Kumar , Vinay Kumar V & Harsha C R
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2,3
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Assistant Professor, Associate Professors, Post graduate, Depart ment of Anatomy,
K.S. Hegde M edical Academy, Nitte Universit y, M angalore, Karnataka, India.
Correspondence:
Raghavendra A Y
Depart ment of Anatomy, K.S. Hegde M edical Academy, Nitte Universit y,
M angalore - 575 018, Kanrataka, India.
M obile : +91 99721 34242 E-mail : raghav4n72@gmail.com
Abstract :
The t hyroid gland is an important and easily approachable endocrine gland, sit uated in t he lower part of anterior aspect of neck. The
Levator glandulae t hyroidea (LGT) is a fibro-musculo-glandular band. It is usually present on t he left side connect ing t he pyramidal lobe
of t hyroid gland to t he hyoid bone. During t he rout ine dissect ion of neck it was observed t hat t he LGT was present on t he right side of
midline of neck ext ending from pyramidal lobe of t he right side of ist hmus of t hyroid gland to t he inferior border of hyoid bone. It was
muscular t hroughout w it h 6.5cm in lengt h, 1.5cm breadt h and 1.75mm in it s t hickness. This is a rare variat ion in t he morphology and
sit uat ion of LGT observed for t he first t ime. The presence of LGT and it s anatomical variat ions gain importance in t he pat hologies related
to t hyroid gland and t heir t reat ment modalit ies.
Keywords: Ist hmus, Thyroid gland, Levator glandulae t hyroidea, M orphology.
Background :
gland to t he hyoid bone. The presence of LGT and it s
The t hyroid gland is t he largest endocrine gland in t he
anatomical variat ions gain importance in t he pat hologies
body. It is an important and easily approachable endocrine
related to t hyroid gland and t heir t reat ment modalit ies
1, 3, 4
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gland, sit uated in t he lower part of anterior aspect of neck .
This case has been presented here to report one of such
It is a horseshoe-shaped mass clasping t he upper part of
variat ions w hich has got a good clinical significance.
t he t rachea. The t hyroid gland consist s of t wo symmet rical
Case Report :
lobes united by an ist hmus, lies in front of t he second, t hird
During t he rout ine dissect ion of neck in an elderly male
and fourt h t racheal ring. A pyramidal lobe of variable size
cadaver, it was observed LGT on t he right side of t he
may be present ext ending from t he ist hmus or from t he
midline of neck ext ending from ist hmus of t hyroid gland to
junct ion of t he ist hmus and one of t he lateral lobes (usually
inferior border of hyoid bone. It was muscular t hroughout
t he left ) and connected to t he t hyroid cart ilage and hyoid
w it h 6.5cm in lengt h, 1.5cm breadt h and 1.75mm in it s
1, 2
bone .
t hickness. Init ially t he skin, superficial fascia and invest ing
There may be in addit ion to t he pyramidal lobe, a
layer of deep fascia were carefully reflected and t he
fibromuscular band know n as t he levator glandulae
ist hmus was ident ified lying at t he level of 2 t racheal ring.
t hyroideae (LGT) w hich
The pyramidal lobe was sit uated on t he right side of t he
usually replace t he upper
midline along t he upper border of t he ist hmus of t hyroid
part of t he pyramidal lobe.
gland. The sternohyoid muscle was ident ified and reflected
The LGT is a fibro-musculo-
above to it s proximal attachment to hyoid bone on bot h
glandular band.
It is
right and left side and LGT was sit uated on right side. The
usually present on t he left
course of t he LGT was carefully dissected. The connect ive
si d e c o n n e c t i n g t h e
t issue sept um was found separat ing it from overlying
pyramidal lobe of t hyroid
sternohyoid and superior belly of omohyoid muscles.
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Keyw ords : Ist hmus, Thyroid gland, Levator glandulae t hyroidea,
M orphology. - Raghavendra A Y
nd
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NUJHS Vol. 5, No.1, M arch 2015, ISSN 2249-7110
Nitte University J ournal of Health Science
Sternot hyroid was found separately on t he lateral side. A
described it in 94 (22.9%) cases in males and 17 (10.6%)
small branch from nerve to omohyoid was found to be
cases in females. They described it as ext ending caudally
supplying t he LGT. On t he left side neit her pyramidal lobe
from t he body of t he hyoid in 53.2% of males and in 52.9%
nor t he LGT was found. The anastomosis bet ween t he
of females, in 10.8% from t he median t hyroid ligament , and
branches of right and left superior t hyroid arteries along
from t he lower border of t he lamina of t he t hyroid in
t he superior border of ist hmus was noted.
34.04% . M arshall found LGT attached to t he hyoid bone in
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17 (28.3%) cases, and in 9 cases it merged w it h t he fascia
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covering t he t hyroid cart ilage . Faysal et al. observed an
unusual case in w hich LGT ext ended from t he apex of t he
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mastoid process . Enayet ullah found LGT in 32% cases and
it s associat ion w it h pyramidal lobe in 22% cases. In most
cases LGT were associated w it h pyramidal lobe and most of
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t he pyramidal lobes were sit uated on t he left side .
Gunapriya et al., reported a case of presence of LGT w it h
absence of pyramidal lobe on t he right side, w hich
st retched from t he upper border of ist hmus of t hyroid
gland, to t he lower border of t he lamina of t hyroid
cart ilage, w hich measured 1 cm in lengt h and 0.6 cm in
Figure 1 : M uscular levator glandulae t hyroidea (LGT) sit uated on
t he right side of midline of t he neck ext ending from pyramidal
lobe of t hyroid gland to lower border of hyoid bone.
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breadt h . Sreekant h Tallapaneni et al., observed t hat t he
LGT was arising from t he upper part of anterior border of
Discussion :
t he t hyroid cart ilage and got inserted into t he substance of
According t o St andring, t he LGT ext ends from t he
rd
t he right lobe along t he lower 2/ 3 of it s anterior border
pyramidal lobe or t he upper border of t he ist hmus usually
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w it h t he agenesis of t he ist hmus .
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on t he left side, to t he body of hyoid bone above .
According to S.D. Joshi et al, t he LGT was present in 27
Conclusion :
(30%) cases. The LGT was attached to hyoid bone in 18
Though previously many aut hors have ment ioned about
(66.66%) instances. It was attached to t he upper border of
t he presence of LGT and it s variat ions, t he present case is a
t hyroid cart ilage in 14 (14.81%) and to t he lower border of
rare one. This st udy signifies t he need for t horough
understanding and t he know ledge of anatomy of t hyroid
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t he t hyroid cart ilage in 5 (18.51%) cases . Harjeet et al.
gland and it s associated variat ions.
References :
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2. Standring S (2006) In: Gray's Anatomy, 39t h Edit ion, London: Elsevier
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Keyw ords : Ist hmus, Thyroid gland, Levator glandulae t hyroidea,
M orphology. - Raghavendra A Y
Anat , 29: 234–339.
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