Which structure, when identified during thyroidectomy, reliably points the surgeon to the entry of the recurrent laryngeal nerve beneath the inferior constrictor?
- A Zuckerkandl tubercle ✓
- B Middle thyroid vein
- C Ligament of Berry
- D Inferior thyroid artery branches
Correct answer: A. Zuckerkandl tubercle
Explanation
The tubercle of Zuckerkandl is the posterolateral projection of the thyroid lobe at the junction of superior and middle thirds. The recurrent laryngeal nerve passes deep or medial to this tubercle before entering the larynx just posterior to the cricothyroid joint, so identifying it leads the dissection safely to the nerve. The inferior thyroid artery branches are variable guides, the middle thyroid vein lies lateral, and the ligament of Berry marks the nerve's distal course but is itself found using the nerve or the tubercle.
Reference: Sabiston Textbook of Surgery, 21st ed.
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