Background. The thesis «thyroid surgery is the surgery of the recurrent laryngeal nerve», which was defined in the XX ­century, remains relevant to this day. Thus, despite the use of modern scientific and technological achievements, vocal cord paresis is diagnosed on average in 9.8% patients after thyroid and parathyroid surgery.

According to many authors, the main problem which a surgeon encounters is a difficult and sometimes individual anatomy of the recurrent laryngeal nerve. For example, in one study authors identified 28 variants of relationships between the ­recurrent laryngeal nerve and the inferior thyroid artery. In a recent meta-analysis, it was noted that the frequency of extralaryngeal branching remains underestimated and reaches 73% of cases. Anatomical variants of the recurrent laryngeal nerve or its thin branches, which have not been noticed in time, can lead to inevitable consequences — to nerve injury and a laryngeal dysfunctions, and if anatomical features are not detected on both sides — to a tragedy.

Aim. The aim of this study is to determine anatomical variants of the extralaryngeal branches of the recurrent laryngeal nerve and their frequency in autopsy case series.

Materials and methods. 46 (100%) recurrent laryngeal nerves were dissected in 23 cadavers. Their path was traced, their relationships with the inferior thyroid artery were determined, and the extralaryngeal branches of the recurrent laryngeal nerve were identified.

Results. Few extralaryngeal branches of the recurrent laryngeal nerve were identified during dissection: tracheoesophageal branches, laryngeal branches, aberrant branches. Tracheoesophageal branches were determined in all cadavers. In 37 (80.4%) cases the recurrent laryngeal nerve had got two or more extralaryngeal laryngeal branches. In 6 (13.0%) cases aberrant branches were presented.

The inferior thyroid artery was detected in 42 (91.3%) cases. The vessel was in close location with the recurrent laryngeal nerve, forming a neuro-arterial chiasm. In 39.1% of cases the recurrent laryngeal nerve was located between the branches of the inferior thyroid artery, in 39.1% of cases — deeper than the artery, and in 10.9% of cases — more superficial than the artery.

Conclusion. The variable anatomical configuration of the recurrent laryngeal nerve inevitably causes difficulties during intraoperative nerve dissection. Tardy identification of these anatomical features can lead to the injury of nerves or its branches, which determines the amount of postoperative vocal cord paresis.

Background. Over the past decades an increase in the incidence of papillary thyroid microcarcinoma (PTMC) has been observed throughout the world owing to the improved diagnostics. There are many different opinions about the aggressiveness degree of this group of tumors, as well as about the tactics of managing patients with PTMC.

Aim of the study is the identification of the prognostic factors responsible for the features of the clinical course, including the more aggressive one.

Materials and methods. A study was carried out with a detailed analysis of a group of patients with papillary thyroid cancer ≤1 cm in size and the existing clinical data of regional and distant metastases. All patients underwent thyroidectomy with bilateral central cervical lymph node dissection. Factors such as gender, patient age, bilaterality, extrathyroid extension, the presence or absence of a capsule around the tumor node, the absence or presence of metastases in the central part were assessed. In 26.6% histological examination revealed metastatic lesions of the central group lymph nodes. Latent metastases were detected in 24.2% of women and 43% of men, in 36.7% of patients <55 and in 14.3% of patients ≥ 55 years, in 29.5% with the absence of the node capsule and in 19.3% with encapsulated tumors, in 48.1% with multicentric growth and in 19.5% with a solitary neoplasm, in 21.7% with a tumor size ≤0.5 cm and in 27.9% with a node of 0.6–1 cm, in 24% with the absence of invasion of the thyroid capsule and in 31% with the presence of extrathyroid invasion, in 21% of patients with typical, in 26% with follicular and 43% with mixed papillary cancer. 95 patients received radioiodine therapy. No additional metastases were found in them.

Results. When conducting univariate analysis, the main signs influencing the development of metastases in the central zone were age up to 55 years (p = 0.009, χ2 = 6.919) and multicentric neoplasm (p = 0.004, χ2 = 8.530); in multivariate analysis, similarly, age younger 55 years (p = 0.000, Exp B = 0.011, CI 95.0% 0.001–0.106) and multifocality (p = 0.027, Exp B = 2.686, CI 95.0% 1.119–6.448).

Conclusion. PTMC is not a separate group or tumor morphotype, and the determination of treatment tactics for this group of patients should be based not only on the size of the tumor, but on the clinical and biological parameters of the tumor.

The article presents the successful experience of surgical treatment of a patient with a malignant tumor of the esophagus, which was detected in a patient with amiodarone-induced thyrotoxicosis. Thyroidectomy made it possible to quickly eliminate thyrotoxicosis and timely perform radical surgery for esophageal cancer.

The choice of tactics for feminizing plastic surgery (one- or two-stage) remains an actually issue. To operate early, in the first months of a child’s life, when endocrinological stabilization is achieved, or to postpone the intervention until puberty? Despite the large number of approaches to surgical treatment, still not all results can be recognized as positive. There are complications that affect the quality of life of patients, not only of a surgical but also of a psychological nature. The advantages of one or another approach are currently impossible to prove, since this will require a prospective multicenter multidisciplinary study of long-term results with each of the approaches. Therefore, pediatric surgeons for a long time in the choice of tactics will be based on accumulated experience and logical reasoning. Given the extensive experience of multidisciplinary rehabilitation, the positive long-term results of two-stage feminization remains the preferred tactic for surgical treatment of girls with CAH. The increased risk of complications from the genitourinary system in the form of infections of the urinary tract, hematocolpos and hematometra in girls with a narrow common urogenital canal, which is inherent in virilization of 3, 4 and 5 degrees according to Prader, can be considered as a reason for an early one-stage feminizing plasty.