Nonrecurrent laryngeal nerve in thyroid surgery: Frequency, anatomical variations according to a new classification and surgery consideration

Head & Neck ◽  
2019 ◽  
Vol 41 (9) ◽  
pp. 2969-2975 ◽  
Author(s):  
Van Quang Le ◽  
Quoc Duy Ngo ◽  
Xuan Quy Ngo
Keyword(s):  
Thyroid Surgery ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
New Classification ◽  
Nonrecurrent Laryngeal Nerve

scholarly journals Anatomical Variations in Recurrent Laryngeal Nerves in Thyroid Surgery

2020 ◽  
pp. 014556132092756 ◽  
Author(s):  
Chuanchang Yin ◽  
Bin Song ◽  
Xiaoyan Wang
Keyword(s):  
Thyroid Surgery ◽  
Vocal Cord Paralysis ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Laryngeal Nerves ◽  
Original Direction ◽  
Nonrecurrent Laryngeal Nerve ◽  
Recurrent Laryngeal Nerves ◽  
The Right

Objective: To study terminal bifurcation of recurrent laryngeal nerves (RLNs) with original direction to larynx entry and to decrease the risk of vocal cord paralysis in thyroid patients. Methods: The RLNs of 294 patients (482 sides) were dissected according to the branches into the larynx, and the original direction of each RLN trunk in thyroid surgery was recorded. Results: (1) About 30.9% of the RLNs gave off multiple branches into the larynx. (2) Two and 3 branches of RLNs into the larynx were found in 25.5% and 5.4% of the cases, respectively. (3) In 0.4% or 2 cases, the RLN trunk combined with the inferior branch of the vagus nerve. (4) Nonrecurrent laryngeal nerve appeared in 2 cases. (5) On the left side, 68.0%, 25.6%, and 6.4% of cases were found with 1, 2, and 3 bifurcations of RLN to larynx entry, respectively. On the right side, 69.8%, 25.8%, and 4.4% cases were identified with 1, 2, and 3 bifurcations of RLN to larynx entry, respectively. (6) The combining dissection approach was proved as successful and safe for protecting the RLN with no permanent RLN paresis. Conclusions: Because of the anatomical variation in RLNs with extralaryngeal bifurcation, it is necessary to increase the awareness of surgeons about these variations so as to protect bifurcated nerves in thyroid surgery.

scholarly journals Nonrecurrent Laryngeal Nerve: A Case Report and Literature Review

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Enrico Maria Amadei ◽  
Christopher Fabbri ◽  
Marco Trebbi
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Thyroid Surgery ◽  
Recent Literature ◽  
Follicular Adenoma ◽  
Laryngeal Nerve ◽  
Inferior Laryngeal Nerve ◽  
Anatomical Variant ◽  
Nonrecurrent Laryngeal Nerve

We report the case of a patient submitted to a right hemithyroidectomy for a follicular adenoma, when we found a nonrecurrent laryngeal nerve. This is a really rare anatomical presentation that can seriously compromise the integrity and preservation of the inferior laryngeal nerve during thyroid surgery. We describe how we found and managed this anatomical variant and we conduct a review of the most recent Literature about nonrecurrent laryngeal nerve.

Anatomical Variations of the Recurrent Laryngeal Nerve During Thyroid Surgery and the Dangers of Nerve Injury

2022 ◽  
Vol 34 (1) ◽  
pp. 35-37
Author(s):  
Amanda J. Bastien ◽  
Allen S. Ho
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Thyroid Surgery ◽  
Anatomical Variations ◽  
Laryngeal Nerve

scholarly journals Anatomical Variations of Recurrent Laryngeal Nerve During Thyroid Surgery: How to Identify and Handle the Variations With Intraoperative Neuromonitoring

2010 ◽  
Vol 26 (11) ◽  
pp. 575-583 ◽  
Author(s):  
Feng-Yu Chiang ◽  
I-Cheng Lu ◽  
Hui-Chun Chen ◽  
Hsiu-Ya Chen ◽  
Cheng-Jing Tsai ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Anatomical Variations ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve

Importance of pre-operative recognition of the nonrecurrent laryngeal nerve

1994 ◽  
Vol 108 (5) ◽  
pp. 417-419 ◽  
Author(s):  
Ikuo Nagayama ◽  
Yozo Okabe ◽  
Hideaki Katoh ◽  
Mitsuru Furukawa
Keyword(s):  
Aortic Arch ◽  
Thyroid Surgery ◽  
Decisive Role ◽  
Laryngeal Nerve ◽  
Barium Swallow ◽  
X Ray ◽  
Aortic Arch Anomaly ◽  
Abnormal Shadow ◽  
Chest X Ray ◽  
Nonrecurrent Laryngeal Nerve

AbstractThe nonrecurrent laryngeal nerve is vulnerable during thyroid surgery. Pre-operative recognition of this nerve allows surgeons to avoid injuring the nerve. This anomaly depends upon the aortic arch anomaly and, therefore, in some cases, surgeons are able to predict the presence of this nerve pre-operatively by chest X-ray or barium swallow. Two patients with nonrecurrent laryngeal nerve are reported, one of whom, a 48-year-old man, had an abnormal shadow of the aortic arch, which led to confirmation of a right aberrant subclavian artery. Barium swallow plays a decisive role in the diagnosis of nonrecurrent laryngeal nerve, and this test is mandatory in patients who complain of difficulty in swallowing.

scholarly journals The Recurrent Laryngeal Nerve in Relation to the Inferior Thyroid Artery in Adult Filipino Cadavers

2011 ◽  
Vol 26 (2) ◽  
pp. 13-17 ◽  
Author(s):  
Jacob S. Matubis ◽  
Karen June P. Dumlao ◽  
Ryner Jose C. Carrillo
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Anatomical Variations ◽  
The Philippines ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Laryngeal Nerves ◽  
Recurrent Laryngeal Nerves ◽  
The Right ◽  
Relationship Of

Objective: To describe the anatomic relationship of the recurrent laryngeal nerve and the inferior thyroid artery in adult cadavers in the Philippines and to compare the proportions of these anatomic relationships with those reported in the foreign literature. Methods: Study design: Descriptive, cross-sectional Setting: University of the Philippines College of Medicine Anatomy Laboratory Subjects: Fifty-four (54)  preserved cadavers (108 sides) dissected within a period from June 2008 to Aug 2010. The anatomy and position of both  the right and the left recurrent laryngeal nerves (RLN) and inferior thyroid arteries (ITA) were noted. The RLN was further classified into 2 variations: non-branching or branching prior to insertion at the cricothyroid joint, under the inferior constrictor muscle.  The ITA was also classified into non-branching and branching.  The results were compared to two foreign studies using a Z-test for two proportions. Results: Fifty four (54) cadavers (108) sides were dissected. Among the  cadavers, both the recurrent laryngeal nerves and inferior thyroid arteries had a maximum of two branches although both the RLNs and ITAs for both the right and left sides were mostly non-branching. The right side of one cadaver was noted to have both a branching RLN and a branching ITA. There were no non-recurrent laryngeal nerves seen among the 54 cadavers. For both left and right sides, the RLN was mostly dorsal to the ITA. Branching RLNs was mostly dorsal to a non-branching ITAs. Most of the non-branching RLNs were dorsal to the ITAs. Non-branching RLNs were usually dorsal to the ITA.               The local patterns of the course of the RLN in relation to the ITA approximates those of Chinese where there is predominance of the RLN dorsal to the ITA  but differs from those of Brazilians where the RLN is usually between ITA branches.    Conclusion: There are multiple anatomical variations with regards to the relationship of the RLN and the ITA. The anatomic variation among Asians may be different from Brazilians. The surgeon’s knowledge of the possible various configurations of the RLN and ITA should be able to help in identification and preservation of the RLN and prevention of complications in thyroid surgery. Keywords: recurrent laryngeal nerve, inferior thyroid  artery, thyroid surgery, Filipino cadavers, anatomical variations

scholarly journals Anatomical Variations of Recurrent Laryngeal Nerve: The Danger in Thyroid Surgery

2019 ◽  
Vol 10 (01) ◽  
pp. 11-15
Author(s):  
Fatogoma Issa Koné ◽  
Siaka Soumaoro ◽  
Naouma Cissé ◽  
N’faly Konaté ◽  
Kassim Diarra ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Anatomical Variations ◽  
Laryngeal Nerve

scholarly journals Ipsilateral nonrecurrent laryngeal nerve palsy and delayed palsy of the contralateral recurrent laryngeal nerve in a case of third-time reoperative thyroid surgery

2019 ◽  
Vol 101 (2) ◽  
pp. e55-e58
Author(s):  
S Wijerathne ◽  
X Goh ◽  
R Parameswaran
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Late Onset ◽  
Contralateral Side ◽  
Laryngeal Nerve ◽  
Aberrant Right Subclavian Artery ◽  
Appropriate Therapy ◽  
Nonrecurrent Laryngeal Nerve ◽  
Reoperative Thyroid Surgery

The occurrence of nonrecurrent laryngeal nerve and delayed nerve palsy of the contralateral nerve occurring simultaneously has never been described. A 67-year-old woman underwent reoperative completion thyroidectomy for enlarging thyroid nodules with recurrent hyperthyroidism and obstructive symptoms. Preoperative computed tomography of the neck showed a large compressive goitre with an aberrant right subclavian artery. At surgery, a type 1 nonrecurrent laryngeal nerve was found and inadvertently transected due to dense adhesions. It was repaired with ansa cervicalis graft. A fully preserved and functional recurrent laryngeal nerve was seen on the contralateral side at the end of surgery. However, the patient developed a delayed palsy on day 4 of the recurrent laryngeal nerve requiring a tracheostomy. Following successful speech and swallowing therapy, the patient was decannulated with good phonation and recovery of the left cord. Patients are at risk of bilateral nerve injury and late onset palsy in reoperative thyroid surgery. Management can be challenging and should be recognised to ensure appropriate therapy.

Sign in / Sign up

Export Citation Format

Share Document