Exposure of occult right upper parathyroid.
(A) Anteroposterior view of the neck showing the initial route of dissection for mobilization of the upper pole, right thyroid lobe. Dissection is kept on the thyroid's surface to avoid injury to the external branch of the right superior laryngeal nerve.
(B) Sharp downward and left retraction of the upper pole (arrow) shows the back of the upper pole and zone of recurrent laryngeal nerve insertion into the larynx.
(C) Sharp left retraction of the upper and lower poles (arrows) rotates the trachea and larynx to expose the posterior esophagus and larynx.
(D) Retraction (arrows) for inspection of the proximal superior thyroid artery and carotid sheath.
Reproduced with permission from: Moore, Jr FD. Secondary and tertiary hyperparathyroidism. In: Mastery of Surgery, Fischer JE, Bland KI, Callery MP (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. Copyright © 2006 Lippincott Williams & Wilkins.
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