Non-recurrent laryngeal nerve

Yetışır, Fahri; Özkardeş, Alper Bilal; Dündar, Halit Ziya; Bozkurt, Birkan; Çiftçi, Ahmet Burak; Kılıç, Mehmet

doi:10.5152/ucd.2013.22

Cited by 7 publications

(11 citation statements)

References 6 publications

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“…Сочетание аберрантной подключичной артерии и НВГН встречается в 89-98% наблюдений [7,9]. Возможно, in vivo за НВГН принимали так называемый ложный НВГН (анастомоз ВГН с симпатиче-ским шейным стволом, анастомоз Галена), который не сопровождается сосудистой аномалией (false non-recurrent laryngeal nerve) [17,18,19].…”

Section: клиническое наблюдениеunclassified

“…По этой причине использование нейромони-торинга в современной хирургии ЩЖ и ОЩЖ является основным методом выявления НВГН. Однако показано, что нейромонито-ринг в редких случаях имеет вариабельные результаты и дает ложнопозитивные импуль-сы за счет наружной ветви верхнего гортан-ного нерва [9,[17][18][19].…”

Section: клиническое наблюдениеunclassified

“…Также наличием коллатеральных веток можно объяснить транзиторные парализа-ции гортани и восстановление иннервации за счет непораженных коллатеральных струк-тур [7]. [9,[17][18][19]. Ограничение применения УЗИ связано с ожирением пациента, загрудин-ным расположением зоба [15].…”

Section: клиническое наблюдениеunclassified

“…Описаны две структуры, сходные по син-топии с НВГН, которые можно ошибочно при-нять за НВГН: симпатическая анастомозиру-ющая ветвь нижнего гортанного нерва (sympathetic-inferior laryngeal nerve anastomotic branch) и анастомоз Галена (Galen's anastomosis) [2,11,14,15,[17][18][19][20].…”

Section: клиническое наблюдениеunclassified

“…Распространенность его составляет 0,3-2,4% [5,6,11,[17][18][19]. Описаны случаи, когда эту ветвь принимали за НВГН (ложный НВГН) и, таким образом, повреждался ис-тинный ВГН [9,11,[17][18][19].…”

Section: клиническое наблюдениеunclassified

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Extralaryngeal variants of the location of the recurrent laryngeal nerve. Clinical observation in thyroid surgery

Malyuga¹,

Александрович²

2017

Endo Serg

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Возвратный гортанный нерв может иметь множество анатомических вариантов при экстраларингеальном расположении, что нередко приводит к смене техники оперативного вмешательства в каждом конкретном случае. В статье описаны два клинических наблюдения выявления невозвращающегося возвратного гортанного нерва и дополнительных коллатеральных анастомозирующих структур возвратного гортанного нерва. Невозвращающий-ся возвратный гортанный нерв, по данным последних исследований, встречается в общей популяции несколько чаще (до 4,8%), чем может предположить практикующий хирург-эндокринолог. Выявление невозвращающегося возвратного гортанного нерва перед операцией является важным объектом исследований. По данным многих авторов, парезы гортани при невозвращающемся возвратном гортанном нерве увеличиваются в разы по сравнению с возвращающимся гортанным нервом. Функциональное и клиническое значение анастомозирующих структур возвратного гортанного нерва до сих пор остается неизвестным. Визуализация их во время операции -редкое явление. Это приводит к их неизбежному повреждению. Таким образом, альтернативой теории тракционных повреждений возвратного гортанного нерва мы видим повреждение его нестандартных анатомических вариантов и анастомозирующих структур. В связи с редкостью выявления таких вариантов экстраларингеального расположения возвратного гортанного нерва считаем целесообразным поделиться собственным опытом. Ключевые слова: невозвращающийся возвратный гортанный нерв, анастомоз Галена, симпатическая анастомозирующая ветвь нижнего гортанного нерва, клиническое наблюдение.The recurrent laryngeal nerve can have a variety of options in extralaryngeal position, which often changes the technique of surgical intervention in each specific case. Below there are two clinical observations of the non-recurrent laryngeal nerve and additional collateral anastomosing structures of the recurrent laryngeal nerve. The non-recurrent laryngeal nerve, according to the recent research, is found in the general population somewhat more often (up to 4.8%) than the practicing surgeon may suggest. The identification of a non-recurrent laryngeal nerve before surgery is an important object of research. According to many authors, the cord palsy in the non-recurrent laryngeal nerve increases many times compared with the recurrent laryngeal nerve. The functional and clinical significance of the anastomosing structures of the recurrent laryngeal nerve is still unknown. To visualize them during surgery is a rare phenomenon, which ultimately leads to their damage. Thus, an alternative to the theory of traction damage of the recurrent laryngeal nerve is the damage to its non-standard anatomical variants and anastomosing structures. Taking into account that such an option of extralaryngeal location of the recurrent laryngeal nerve is so rare, we consider it appropriate to share our own experience.

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Section: клиническое наблюдениеunclassified

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Extralaryngeal variants of the location of the recurrent laryngeal nerve. Clinical observation in thyroid surgery

Malyuga¹,

Александрович²

2017

Endo Serg

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Two Concomitant Right Nonrecurrent Laryngeal Nerves Encountered During Thyroidectomy (Type 4 Course): Reported for the First Time

Mohammed

Arif

2020

Ear Nose Throat J

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Introduction: The recurrent laryngeal nerve gains its name because after branching from the vagus nerve, it turns superiorly (recur) around the subclavian artery on the right and around the ligamentum arteriosum on the left, the nonrecurrent nerve has a straight direct course to the larynx and doesn’t follow this course. It presents mostly on the right side. The presence of this variation places the nerve at higher risk of injury during neck surgery especially thyroid operations. Case Presentation: A 45-year-old lady presented with painless thyroid enlargement for 1 year. Thyroid examination showed a 3-cm firm nodule at the right thyroid lobe with normal thyroid function tests. Right thyroid lobectomy was done and the histopathology showed a benign follicular lesion. During surgery, we discovered 2 nonrecurrent laryngeal nerves at the right side which were arising from the vagus nerve and both were entering the larynx. Conclusion: Failure in identification of the nerve or overlooking the possibility of the non-recurrent laryngeal nerve may result in a serious sequelae of nerve damage, ipsilateral injury may lead to permanent hoarseness and bilateral injury may result in severe dyspnea or aphonia. Currently, there are 3 types of nonrecurrent laryngeal nerve courses. Type 1 passes near to the superior thyroid vessels. Type 2 (2A) passes parallel to the inferior thyroid artery and has a transverse course above it. Type 3 (2B) passes parallel to the inferior thyroid artery and transversely between branches of or under the inferior thyroid artery, we can add to this classification type 4, which are 2 nonrecurrent laryngeal nerves (double nerves) passing above and parallel to the inferior thyroid artery.

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Phoniatric evaluation, diagnosis and treatment of voice disorders in the laryngeal nerves paralysis

Jurkiewicz¹,

Markowska²

2022

J Pre Clin Clin Res.

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Objective. The aim of the study was to specify and collect important information on the anatomy of the laryngeal nerves and the types of paralysis, as well as paresis and fixation, which is not due to dysfunction of the recurrent laryngeal nerve, but is caused by immobility of the vocal fold as a result of a mechanical obstruction. We focused on the analysis of this condition in terms of clinical symptoms contributing to phoniatric disorders, including dysphonia in the majority of patients with palsy of the laryngeal nerves, as well as the occurrence of dysphagia in slightly more than 30% of people suffering from paralysis. Changes in the patient's quality of life are significant enough to develop the subject in terms of presenting the possibilities of diagnosis, and to present the types of treatment of phoniatric dysfunctions, because an increasing number of patients decide to undergo surgical rehabilitation, including such surgical procedures as thyreoplasty,aimed at improving the quality of life of patients. Review Methods. The focus was on finding the most up-to-date information from the world of science, both on the Internet and in printed literature. Searching Internet resources was carried out with the use of medical publication databases Embase and UpToDate. In addition, part of the bibliography was found on PubMed and PubMed Central. The exploration process was based on key words. A review of the literature was carried out using the basic terms: retrograde laryngeal nerve, in combination with the following entries: paralysis, aphonia, diagnosis, treatment. All the publications selected, with one exception about acute bilateral recurrent palsy of the laryngeal nerve, published in 1988, were published in the 21st century. Special emphasis was placed on presenting the most up-to-date knowledge possible, therefore the vast majority of the literature was published after 2014. Several items published in the current calendar year can be found in the bibliography. Clinical trials were also taken into account, paying particular attention to the number of patients tested, the selection of the research group, research methods and analysis of the results. Many of the online sources found did not meet the selected criteria, most often because the subject was incomplete or the results were reported from too small a group of patients. The criteria adopted while browsing the printed literature were primarily the year of publication and the thematic scope of the issues described.

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Non-recurrent laryngeal nerve

Cited by 7 publications

References 6 publications

Extralaryngeal variants of the location of the recurrent laryngeal nerve. Clinical observation in thyroid surgery

Extralaryngeal variants of the location of the recurrent laryngeal nerve. Clinical observation in thyroid surgery

Two Concomitant Right Nonrecurrent Laryngeal Nerves Encountered During Thyroidectomy (Type 4 Course): Reported for the First Time

Phoniatric evaluation, diagnosis and treatment of voice disorders in the laryngeal nerves paralysis

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