Which of the following correctly characterises the Delphian node and its significance during thyroid surgery?
- A It is a Level VI node lying in the tracheoesophageal groove; involvement implies T4 disease
- B It is a Level IIB jugulodigastric node; positive status requires modified radical neck dissection
- C It is a prelaryngeal/precricoid node in the midline; a positive frozen section mandates central compartment dissection ✓
- D It drains directly to the thoracic duct and is sampled to detect occult lateral nodal disease
Correct answer: C. It is a prelaryngeal/precricoid node in the midline; a positive frozen section mandates central compartment dissection
Explanation
The Delphian node (oracle node) is a prelaryngeal/precricoid midline lymph node found in the fascia overlying the larynx. Its name derives from the Oracle of Delphi because a positive intraoperative frozen section for papillary thyroid carcinoma reliably predicts central compartment (Level VI) nodal disease, prompting prophylactic central neck dissection. It is not a Level VI tracheoesophageal groove node.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.