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Anatomical variations of the recurrent laryngeal nerve according to the inferior thyroid artery and their clinical impact in patients undergoing thyroidectomy

Published online by Cambridge University Press:  20 June 2022

E Gkrinia Open the ORCID record for E Gkrinia [Opens in a new window] ,
P Nana ,
K Spanos ,
A Fiska ,
J Hajiioannou Open the ORCID record for J Hajiioannou [Opens in a new window] ,
C Skoulakis  and
A H Zibis
E Gkrinia*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
P Nana
Affiliation:
Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
K Spanos
Affiliation:
Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
A Fiska
Affiliation:
Department of Anatomy, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece
J Hajiioannou
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
C Skoulakis
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
A H Zibis
Affiliation:
Department of Anatomy, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
*
Author for correspondence: Dr Eleni Gkrinia, Department of Otolaryngology – Head and Neck Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece E-mail: gkrinia.eleni@gmail.com
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Abstract

Background

Recurrent laryngeal nerve identification is the ‘gold standard’ in thyroidectomy, to determine nerve function security and prevent severe complications. This study assessed the topographical relationship between the recurrent laryngeal nerve and the inferior thyroid artery in patients undergoing total thyroidectomy, and determined its clinical impact.

Methods

A retrospective study was performed of patients undergoing total thyroidectomy in a single tertiary centre over a six-month period.

Results

Sixty-four patients were included. Among the 128 recurrent laryngeal nerve dissections, the nerve was identified traversing the inferior thyroid artery anteriorly in 27.3 per cent, with equal distribution between the two sides. No significant sex association was reported. One patient had transient vocal fold palsy, and hypocalcaemia was observed in 21.9 per cent, yet there was no statistical association with the topographical variation of the recurrent laryngeal nerve.

Conclusion

Almost one-third of patients had an anatomical variation in which the recurrent laryngeal nerve ran superiorly to the inferior thyroid artery. Recurrent laryngeal nerve variation had no clinical impact on local complications or hypocalcaemia.

Keywords

Recurrent Laryngeal NerveThyroidectomyVocal Cord ParalysisHypocalcemia
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 6 , June 2023 , pp. 673 - 677
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mrs E Gkrinia takes responsibility for the integrity of the content of the paper

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