Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T23:36:32.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-recurrent laryngeal nerve related to thyroid surgery: report of three cases

Published online by Cambridge University Press:  22 May 2007

C Page ,
P Monet ,
J Peltier ,
B Bonnaire  and
V Strunski
C Page*
Affiliation:
Department of ENT and Head & Neck Surgery, University Hospital of Amiens, Amiens, France Department of Anatomy, School of Medicine, ‘Jules Verne’University of Picardie, Amiens, France
P Monet
Affiliation:
Department of Medical Imaging, University Hospital of Amiens, Amiens, France
J Peltier
Affiliation:
Department of Anatomy, School of Medicine, ‘Jules Verne’University of Picardie, Amiens, France
B Bonnaire
Affiliation:
Department of Medical Imaging, University Hospital of Amiens, Amiens, France
V Strunski
Affiliation:
Department of ENT and Head & Neck Surgery, University Hospital of Amiens, Amiens, France
*
Address for correspondence: Dr Cyril Page, CHU Amiens – Hôpital Nord, Service d'ORL et de chirurgie cervico-faciale, Place Victor Pauchet, F-80054 Amiens Cedex 1, France. E-mail: cyril.page@caramail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose of the study:

We aimed to highlight a rare anatomical variation involving the recurrent laryngeal nerve, and to emphasise its implications for thyroid surgery.

Materials and methods:

Over a period of 13 years, 993 patients underwent thyroid surgery; 1557 recurrent laryngeal nerves (887 on the right side) were exposed.

Results:

Three non-recurrent laryngeal nerves were found on the right side, associated with a retro-oesophageal subclavian artery. One case was suspected before surgery.

Discussion:

Several variations in the path and branches of the recurrent laryngeal nerve have been reported in the literature. The frequency of occurrence of a non-recurrent laryngeal nerve is about 1 per cent, for patients undergoing thyroid surgery. Other surgically relevant anatomical variations of the recurrent laryngeal nerve include associations with the inferior thyroid artery and the presence of nerve branches.

Conclusion:

The recurrent laryngeal nerve must be carefully dissected and totally exposed during thyroid surgery in order to best preserve its function. Moreover, the thyroid surgeon must be aware of the existence of anatomical variations, which are not as rare as one may think.

Keywords

Thyroid GlandRecurrent Laryngeal NerveThyroidectomyAnatomy
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 7 , July 2008 , pp. 757 - 761
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Cagnol, G, Santini, J, Demard, F. Anatomy of the recurrent nerve. Descriptive anatomy, trajectory and relationships, variations. Acta Otorhinolaryngol Belg 1987;41:821–7Google Scholar
2 Flament, JB, Delattre, JF, Palot, JP. Anatomic pitfalls during dissection of the recurrent laryngeal nerve [in French]. J Chir (Paris) 1983;120:329–33Google Scholar
3 Morrisson, LF. Recurrent laryngeal nerve paralysis: a revised conception based on the dissection of 100 cadavers. Ann Otol Rhinol Laryngol 1952;61:567–92Google Scholar
4 Page, C, Foulon, P, Strunski, V. The inferior laryngeal nerve: surgical and anatomic considerations. Report of 251 thyroidectomies. Surg Radiol Anat 2003;25:188–91Google Scholar
5 Reeve, T, Coupland, G, Johnson, D, Buddee, F. The recurrent and external laryngeal nerves in thyroidectomy. Med J Aust 1969;1:380–2Google Scholar
6 Sun, SQ, Zhao, J, Lu, H, He, GQ, Ran, JH, Peng, WH. An anatomical study of the recurrent laryngeal nerve: its branching patterns and relationship to the inferior thyroid artery. Surg Radiol Anat 2001;23:363–9Google Scholar
7 Avisse, C, Marcus, C, Delattre, JF, Marcus, C, Cailliez-Tomasi, JP, Palot, JP et al. Right non recurrent inferior laryngeal nerve and arteria lusoria: the diagnostic and therapeutic implications of an anatomic anomaly. Review of 17 cases. Surg Radiol Anat 1998;20:227–32CrossRefGoogle ScholarPubMed
8 Pemberton, J, Beaver, MG. Anomaly of the right recurrent laryngeal nerve. Surg Gynecol Obstet 1932;54:594–5Google Scholar
9 Berlin, DD. The recurrent laryngeal nerves in total ablation of the normal thyroid gland. An anatomical and surgical study. Surg Gynecol Obstet 1935;60:19–26Google Scholar
10 Ardito, G, Manni, R, Vicenzoni, C, Modugno, P, Guidi, ML. The non recurrent inferior laryngeal nerve. Surgical experience. Ann Ital Chir 1998;69:21–4Google Scholar
11 Defechereux, T, Albert, V, Alexandre, J, Bonnet, P, Hamoir, E, Meurisse, M. The inferior non recurrent laryngeal nerve: a major surgical risk during thyroidectomy. Acta Chir Belg 2000;100:62–7Google Scholar
12 Proye, C, Dumont, HG, Depadt, G, Lagache, G. The non recurrent laryngeal nerve, a danger in thyroid surgery [in French]. Ann Chir 1982;36:454–8Google ScholarPubMed
13 Vallicioni, J, Ndiaye, M, Poissonnet, G, Dassonville, O, Converset, S, Lecoq, M et al. Non recurrent inferior laryngeal nerve: review of 13 cases [in French]. Ann Otolaryngol Chir Cervicofac 2003;120:268–70Google Scholar
14 Vuillard, P, Bouchet, A, Gouillat, C, Armand, D. Non recurrent inferior laryngeal nerve (15 operative cases) [in French]. Bull Assoc Anat (Nancy) 1978;62:497–505Google Scholar
15 Wijetilaka, SE. Non-recurrent laryngeal nerve. Br J Surg 1978;65:179–81Google Scholar
16 Henry, JF, Audiffret, J, Denizot, A, Plan, M. The non recurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery 1988;104:977–84Google Scholar
17 Raffaelli, M, Iacobone, M, Henry, JF. The “false” non recurrent inferior laryngeal nerve. Surgery 2000;128:1082–7Google Scholar
18 Deveze, A, Sebag, F, Hubbard, J, Jaunay, M, Maweja, S, Henry, JF. Identification of patients with a non-recurrent inferior laryngeal nerve by duplex ultrasound of the brachiocephalic artery. Surg Radiol Anat 2003;25:263–9CrossRefGoogle ScholarPubMed
19 Nagayama, I, Okabe, Y, Katoh, H, Furukawa, M. Importance of pre-operative recognition of the non recurrent laryngeal nerve. J Laryngol Otol 1994;108:417–19Google Scholar