Recurrent Laryngeal Nerve Dissection

1980 ◽  
Vol 45 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Frank B. Wilson ◽  
D. J. Oldring ◽  
Kathleen Mueller
Keyword(s):  
Surgical Treatment ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Recurrent Nerve ◽  
Successful Management ◽  
Initial Surgery ◽  
The Subject ◽  
The Right

This case study describes successful management of spastic dysphonia using a procedure whereby the right recurrent laryngeal nerve was severed. Thirteen months following the surgical treatment, the subject reported a return of the preoperative vocal characteristics of spastic dysphonia. Tests and inspection revealed that the right recurrent nerve was again intact and the right vocal fold was functional. A second surgical procedure was performed, modified to prevent neural reconnection, with a return of the improved voice observed following the initial surgery. The results are discussed in terms of etiological considerations of spastic dysphonia.

Characteristic travelling patterns of non-recurrent laryngeal nerves

2014 ◽  
Vol 128 (6) ◽  
pp. 534-539 ◽  
Author(s):  
K H Hong ◽  
H T Park ◽  
Y S Yang
Keyword(s):  
Computed Tomography ◽  
Recurrent Laryngeal Nerve ◽  
Subclavian Artery ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
New Classification ◽  
Laryngeal Nerves ◽  
Brachiocephalic Trunk ◽  
Recurrent Laryngeal Nerves ◽  
The Right

AbstractBackground:The non-recurrent laryngeal nerve is subject to potential injury during thyroid surgery. Intra-operative identification and preservation of this nerve can be challenging. Its presence is associated with an aberrant subclavian artery and the developmental absence of the brachiocephalic trunk. This study aimed to evaluate the incidence of non-recurrent laryngeal nerves and present a new classification system for the course of these nerves.Methods:Non-recurrent laryngeal nerves were identified on the right side in 15 patients who underwent thyroidectomy. The incidence of non-recurrent laryngeal nerves (during thyroidectomy) and aberrant subclavian arteries (using neck computed tomography) was evaluated, and the course of the nerves was classified according to their travelling patterns.Results:The overall incidence of non-recurrent laryngeal nerves was 0.68 per cent. The travelling patterns of the nerves could be classified as: descending (33 per cent), vertical (27 per cent), ascending (20 per cent) or V-shaped (20 per cent).Conclusion:Clinicians need to be aware of these variations to avoid non-recurrent laryngeal nerve damage. A retroesophageal subclavian artery (on neck computed tomography) virtually assures a non-recurrent laryngeal nerve. This information is important for preventing vocal fold paralysis. Following a review of non-recurrent laryngeal nerve travelling patterns, a new classification was devised.

scholarly journals Surgical Delight: Nonrecurrent Laryngeal Nerve

2015 ◽  
Vol 7 (1) ◽  
pp. 14-16
Author(s):  
Krishnan Ravikumar ◽  
Dhalapathy Sadacharan
Keyword(s):  
Case Report ◽  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Postoperative Period ◽  
Anatomic Variation ◽  
Laryngeal Nerve ◽  
Recurrent Nerve ◽  
Complete Evaluation ◽  
Nonrecurrent Laryngeal Nerve ◽  
The Right

ABSTRACT Introduction A nonrecurrent course is an unusual anatomic variation of the recurrent laryngeal nerve. It is seen usually on the right side, and it is very rare on the left side. Nonrecurrent laryngeal nerve if present is mostly associated with vascular anomalies. Case report A 55-year-old female was referred to us with thyrotoxic symptoms for a period of 6 months. She was rendered euthyroid with antithyroid medications. After complete evaluation, she was posted for total thyroidectomy. Intraoperatively, right recurrent nerve could not be identified in usual position. On careful dissection, a nonrecurrent laryngeal nerve was identified. The recurrent laryngeal nerve on the left side showed normal course. The intraoperative and postoperative period were uneventful. Postoperative vocal cord status was normal. Conclusion This case was presented for its rarity and to stress the need for orderly meticulous surgical dissection. How to cite this article Ravikumar K, Sadacharan D, Suresh Rv. Surgical Delight: Nonrecurrent Laryngeal Nerve. World J Endoc Surg 2015;7(1):14-16.

scholarly journals A Unique Case of Intraabdominal Polyorchidism: A Case Study

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Javier Otero ◽  
Natalie Ben-Yakar ◽  
Biruk Alemayehu ◽  
Steven D. Kozusko ◽  
Frank Borao ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Surgical Treatment ◽  
Conservative Approach ◽  
Undescended Testes ◽  
Unique Case ◽  
Surgical Exploration ◽  
Body Of Knowledge ◽  
The Subject ◽  
The Right

Background. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations.Questions/Purposes. To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery’s body of knowledge of the subject matter.Case Study. A nine-month-old boy was admitted for an impalpable right testis and phimosis. At the time of surgical exploration, there appeared to be polyorchid testis on the right-hand side, with three masses that potentially appeared to be undescended testes.Discussion. Proponents of a conservative approach argue that infertility is common in patients with polyorchidism and, by preserving a potentially functional SNT, there may be improved spermatogenesis. When performing definitive surgical treatment, meticulous intra-abdominal and intrainguinal exploration must be undertaken. Orchiopexy should be performed to reduce the chances of torsion, malignancy, and infertility.Conclusion. Our case is important to the literature as it is the first known case of polyorchidism with 3 SNT on the right side, located intra-abdominally, and in a patient less than 1 year of age.

Erratum: Recurrent Laryngeal Nerve Dissection

1980 ◽  
Vol 45 (3) ◽  
Author(s):  
Frank B. Wilson ◽  
D. J. Oldring ◽  
Kathleen Mueller
Keyword(s):  
Case Report ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Long Period ◽  
Initial Surgery

On page 112 of the report by Wilson, Oldring, and Mueller ("Recurrent Laryngeal Nerve Dissection: A Case Report Involving Return of Spastic Dysphonia after Initial Surgery," pp. 112-118), the paraphrase from Cooper (1971), "if the patients are carefully selected and are willing to remain in therapy for a long period of time," was inadvertantly put in quotation marks.

Anatomical and developmental aspects of iatrogenic injury to the right recurrent laryngeal nerve in surgical resections of substernal goiter

2021 ◽  
Author(s):  
Rossano Kepler Alvim Fiorelli ◽  
Alfredo Jorge Vasconcelos Duarte ◽  
Aline de Quadros Teixeira ◽  
Thiago Scharth Montenegro ◽  
Pedro Eder Portari Filho ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Iatrogenic Injury ◽  
Substernal Goiter ◽  
The Right

Correlation between Stroboscopy and Electromyography in Laryngeal Paralysis

1993 ◽  
Vol 102 (11) ◽  
pp. 852-857 ◽  
Author(s):  
John Kokesh ◽  
Lawrence R. Robinson ◽  
Paul W. Flint ◽  
Charles W. Cummings
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Therapeutic Intervention ◽  
Vocal Fold ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Previous Surgery ◽  
Laryngeal Paralysis ◽  
The Status ◽  
Laryngeal Nerve Injury ◽  
Vocal Fold Motion

Twenty patients with vocal fold motion impairment were reviewed to correlate the findings of electromyography (EMG) and stroboscopy. The causes of motion impairment were idiopathic, previous surgery with recurrent laryngeal nerve injury, neck and skull base trauma, and neoplasm. The EMG studies were analyzed to assess the status of innervation of the immobile vocal fold. The presence or absence of the mucosal wave prior to therapeutic intervention was determined with stroboscopic examination. Eight of 10 patients with EMG evidence of reinnervation or partial denervation were found to have mucosal waves, and 3 of 10 patients with EMG evidence of denervation were found to have mucosal waves. Six patients developed mucosal waves after surgical medialization, despite evidence of denervation by EMG criteria. These findings support the premise that tension and subglottic pressure, rather than status of innervation, determine the presence of the mucosal wave.

Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Membrane Oxygenation ◽  
The Right ◽  
Unilateral Vocal Cord Paralysis

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

Recurrent laryngeal nerve palsy secondary to benign thyroid disease

1994 ◽  
Vol 108 (10) ◽  
pp. 878-880 ◽  
Author(s):  
J. E. Fenton ◽  
C. I. Timon ◽  
D. P. McShane
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Disease ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Recurrent Nerve ◽  
Benign Thyroid Disease ◽  
Nerve Paralysis ◽  
Benign Thyroid

Abstract: A recurrent nerve palsy occurring in the presence of a goitre is considered to be caused by thyroid malignancy until proven otherwise.Three cases are described in which benign thyroid disease resulted in recurrent laryngeal nerve paralysis. Recent haemorrhage was implicated histologically as the possible aetiology in all three cases. The importance of identifying and preserving the recurrent laryngeal nerve in the surgical management is highlighted.

scholarly journals Anatomical Variations of the Recurrent Laryngeal Nerve and Implications for Injury Prevention during Surgical Procedures of the Neck

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 670
Author(s):  
Alison M. Thomas ◽  
Daniel K. Fahim ◽  
Jickssa M. Gemechu
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Surgical Procedures ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Branching Pattern ◽  
The Right ◽  
Relationship Of ◽  
Intrinsic Laryngeal Muscles ◽  
Formalin Fixed

Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential anatomical variability of RLN pertaining to its course, branching pattern, and relationship to the inferior thyroid artery, which makes it vulnerable during surgical procedures of the neck. Fifty-five formalin-fixed cadavers were carefully dissected and examined, with the course of the RLN carefully evaluated and documented bilaterally. Our findings indicate that extra-laryngeal branches coming off the RLN on both the right and left side innervate the esophagus, trachea, and mainly intrinsic laryngeal muscles. On the right side, 89.1% of the cadavers demonstrated 2–5 extra-laryngeal branches. On the left, 74.6% of the cadavers demonstrated 2–3 extra-laryngeal branches. In relation to the inferior thyroid artery (ITA), 67.9% of right RLNs were located anteriorly, while 32.1% were located posteriorly. On the other hand, 32.1% of left RLNs were anterior to the ITA, while 67.9% were related posteriorly. On both sides, 3–5% of RLN crossed in between the branches of the ITA. Anatomical consideration of the variations in the course, branching pattern, and relationship of the RLNs is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy and anterior cervical discectomy and fusion (ACDF) surgery. The information gained in this study emphasizes the need to preferentially utilize left-sided approaches for ACDF surgery whenever possible.

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