World Journal of Endocrine Surgery

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VOLUME 3 , ISSUE 1 ( January-April, 2011 ) > List of Articles

REVIEW ARTICLE

The Nonrecurrent Laryngeal Nerve in Thyroid Surgery

Dennis Kraus, Ashok R Shaha, James Paul O'Neill, Jennifer La Femina

Citation Information : Kraus D, Shaha AR, O'Neill JP, Femina JL. The Nonrecurrent Laryngeal Nerve in Thyroid Surgery. World J Endoc Surg 2011; 3 (1):1-2.

DOI: 10.5005/jp-journals-10002-1044

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

A nonrecurrent laryngeal nerve is a rare anomaly and estimated to be present in 0.25 to 0.99% of patients.1 The identification and preservation of the recurrent laryngeal nerve is an essential part of thyroid surgery. It is now well-known that the recurrent laryngeal nerve is not only a single nerve but also a complex branching network of innervation. Thyroid surgery demands a precise understanding of the anatomical intimacy between the gland and surrounding structures, including the parathyroid glands and neurovascular tissue. The morbidity associated with thyroid surgery, in the short-term, generally relates to hematoma collection and hypocalcemia. Long-term morbidity is more commonly seen with dysphonia and vocal cord dysfunction due to superior laryngeal nerve damage and its role in explosive sound formation, the recurrent laryngeal nerve, its tortuous anatomical course, and its role in laryngeal musculature innervation.

We review the literature on this subject and report three cases of the rare nonrecurrent anomaly, firstly a 75-year-old lady with a large retrosternal goiter. During her initial work-up which included a CT scan of the thorax, an ‘arteria lusoria' was identified in the retroesophageal plane. Intraoperatively, a right-sided nonrecurrent inferior laryngeal nerve (NRILN) was identified. The second case is of a 63-year-old lady with a right-sided type 1 nonrecurrent laryngeal nerve which we identified and photographed when medially retracting the gland off the central compartment and ligament of Berry. The third case is that of a 45-year-old lady with a right-sided thyroid nodule and a right-sided NRILN identified intraoperatively.


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  1. The nonrecurrent inferior laryngeal nerve: Review of 33 cases, including two on the left side. Surgery 1988;104:977-84.
  2. The recurrent laryngeal nerve in thyroid surgery. Surgeon 2008;6:373-77.
  3. Non-recurrent laryngeal nerve related to thyroid surgery: Report of three cases. J Laryngol Otol 2008;122:757-61.
  4. The inferior non-recurrent laryngeal nerve: A major surgical risk during thyroidectomy. Acta Chir Belg 2000;100:62-67.
  5. The non-recurrent laryngeal nerve: A danger in thyroid surgery. Ann Chir 1982;36, 454-58.
  6. Non-Recurrent laryngeal nerve. Br J Surg 1978;65: 179-81.
  7. The false non-recurrent inferior laryngeal nerve. Surgery 2000;128:1082-87.
  8. The usefulness of preoperative ultrasonographic identification of nonrecurrent inferior laryngeal nerve in neck surgery. Langenbecks Arch Surg 2008;393:633-38.
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