Original communicationAnatomic configurations of the recurrent laryngeal nerve and inferior thyroid artery
Section snippets
Material and methods
Fifty specimens (100 sides) were examined for this project, including 36 male and 14 female cadavers between the ages of 38 and 87 years at death. Medical records for the subject included no histories of neck or superior mediastinum disorders during life. Cause of death was unrelated to the organs of head and neck, which were examined carefully to be sure that they showed no signs of trauma, deformities, tumors, or significant volume loss. Dissection was performed from posterior of the
Results
A total 100 RLNs were investigated in this study. During its lengthy ascent, the nerve was found residing on the trachea, lying in the tracheoesophageal groove, or was separated from it by fat and connective tissue. The RLN was divided into the anterior and posterior branches, entering to the larynx at the third superior of its course. The ITA was observed in 96 sides. It originated from the thyrocervical trunk and passed the inferior pole of the thyroid gland. The artery divided into the
Discussion
Thyroidectomy is the surgery in which the RLN injury occurs most frequently. Its incidence in thyroidectomies ranges from 0% to 12%.6, 7, 8, 9, 10, 11 This injury occurs more frequently when a branch of the ITA is sectioned inadvertently. In an attempt to achieve hemostasis, the nerve is clipped or separated with the arterial branch.6, 7, 8, 12 Even though some investigators'13 defend the display of the RLN only in specific situations, with the development of modern thyroid surgery it has been
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Anatomical variations of the thyroid gland: An experimental cadaveric study
2021, Annals of Medicine and SurgeryCitation Excerpt :In contrast, some studies [16,17] proposed that the most common origin for the STA was from the bifurcation directly. One of the possible causes for this inconsistency can be due to the very short distance between where the STA would originate on the ECA and the bifurcation, making it difficult to distinguish the 2 sites accurately [18]. Variations in the relationship between the ITA and the recurrent laryngeal nerve also pose surgical relevance.
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2021, Surgery of the Thyroid and Parathyroid GlandsMechanisms of recurrent laryngeal nerve injury near the nerve entry point during thyroid surgery: A retrospective cohort study
2020, International Journal of SurgeryCitation Excerpt :The RLN in approximately 25% of patients runs through the dense fibers of the Berry's ligament [46]. The RLN may be compressed between the trachea and a dense fibrous band or crossing artery, especially within the region of the Berry's ligament [13,46–48]. The influence of the excessive stretching on thermal injury may be that the space between the RLN and thyroid is difficult to release because the fiber of Berry's ligament has high tension.
Effect of intraoperative neuromonitoring on recurrent laryngeal nerve palsy rates after thyroid surgery-A meta-analysis
2013, Journal of the Formosan Medical AssociationCitation Excerpt :The average incidences of permanent and temporary RLN palsy after thyroid operations are high (2.3% and 9.8%, respectively), as verified by systematic and rigorous postoperative laryngoscopy.2 Most surgeons apply their best efforts to prevent this considerable postoperative complication, which involves hoarseness, impaired vocal register, dysphonia, dysphagia, and aspiration dyspnea.3 The rate of RLN palsy depends on the type of disease (benign or malignant), the extent of thyroid resection (subtotal or total thyroidectomy), the type of resection (first time or reoperation), the surgical device used (with or without routine RLN identification), and the training and/or experience of the surgeon.4–6
An Exposition on Surgical Experiences in Identification, Exposure, and Injuries of Recurrent Laryngeal Nerve (RLN) During Thyroid Operations: Gleanings, Narrative, and the Reflections
2023, Indian Journal of Otolaryngology and Head and Neck Surgery