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Non-recurrent inferior laryngeal nerve identification during robotic thyroidectomy

Published online by Cambridge University Press:  30 January 2014

C-C Wang  and
C-H Wu
C-C Wang*
Affiliation:
School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Otolaryngology, Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan School of Speech Language Pathology and Audiology, Chung-Shan Medical University, Taichung, Taiwan
C-H Wu
Affiliation:
Department of Radiology, Taichung Veterans General Hospital, Taipei, Taiwan Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
*
Address for correspondence: Dr C-C Wang, Department of Otolaryngology, Head and Neck Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung 40705, Taiwan Fax: +886-4-23596868 E-mail: entccwang@msn.com
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Abstract

Objective:

A non-recurrent inferior laryngeal nerve is a rare anomaly in which the nerve enters the larynx directly off the cervical vagus nerve, without descending to the thoracic level. It is very susceptible to damage during surgery. This report describes the important pre-operative radiological evaluations and surgical landmarks in a case of a non-recurrent inferior laryngeal nerve, identified during the recently developed technique of robotic thyroidectomy.

Case report:

A 38-year-old woman presented with suspected papillary microcarcinoma, as indicated by aspiration cytology. Pre-operative computed tomography showed a right aberrant subclavian artery that indicated a possible right non-recurrent inferior laryngeal nerve. Using robotic thyroidectomy methods, it was possible to carefully dissect along the thyroid capsule. The laryngeal entrance point of the right non-recurrent inferior laryngeal nerve (a constant anatomical landmark) was successfully identified via the three-dimensional, high-magnification views provided by the robotic endoscope.

Conclusion:

With proper knowledge of radiological and surgical anatomy, and the benefits of high-magnification endoscopic views, a non-recurrent inferior laryngeal nerve can be safely preserved during robotic surgery.

Keywords

ThyroidectomyRecurrent Laryngeal NerveAnatomyRoboticsAberrant Subclavian Artery
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 199 - 202
Copyright
Copyright © JLO (1984) Limited 2014 

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