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

Page, C.; Monet, P.; Peltier, Johann; Bonnaire, B.; Strunski, V.

doi:10.1017/s0022215107008389

Cited by 37 publications

(41 citation statements)

References 12 publications

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“…A diagnosis of an aberrant subclavian artery with neck CT images is sound, as it is based on the direct identification of an aberrant artery passing behind the oesophagus. 10 Many patients undergo CT study of the neck before thyroid surgery to evaluate the anatomical relationships between the thyroid gland and the surrounding structures, especially the lateral neck lymph nodes. Thus, the identification of an aberrant subclavian artery can be reliably established using only CT images.…”

Section: Discussionmentioning

confidence: 99%

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Characteristic travelling patterns of non-recurrent laryngeal nerves

2014

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Section: Discussionmentioning

confidence: 99%

“…In such an instance, the nerve may meet the inferior thyroid artery rather than passing underneath it, as it usually does. 10 Abboud and Aouad 11 reported only three cases of non-RLNs and classified the three types as horizontal, transverse and downward direction.…”

Section: Introductionmentioning

confidence: 99%

Characteristic travelling patterns of non-recurrent laryngeal nerves

2014

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“…[17][18][19] RLN is the nerve of the sixth branchial arch and associated with sixth arch arteries with the ventral branches form the pulmonary arteries. 14 The right subclavian artery and the aortic arch on the left is formed by the fourth arch arteries while the dorsal branches of the fifth and sixth arteries disappear.…”

Section: Discussionmentioning

confidence: 99%

Retroesophageal Right Subclavian Artery with Nonrecurrent Laryngeal Nerve: Unique Variation of Surgical Importance

Gupta¹,

Naik²,

Halkud³

et al. 2013

World Journal of Endocrine Surgery

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A nonrecurrent laryngeal nerve (NRLN) is a rare anatomical variant and is not detected on routine preoperative imaging. NRLN is related with absence of the brachiocephalic trunk and aberrant retroesophageal course of the right subclavian artery (arteria lusoria) which is evident on contrast-enhanced computerized tomographic (CT) scan of the chest. We report three cases of NRLN accidentally documented during total thyroidectomies for papillary carcinoma of the thyroid. All the three NRLNs seen on the right side were of the type IB variety. All the three NRLN were seen with its direct branch from the vagus at the level of the isthmus entering the cricothyroid muscle 2.5 to 3 cm away from the vagus without a recurrent course. Reviewing of contrast-enhanced CT scan of the chest revealed retroesophageal right subclavian artery (arteria lusoria) a variation of type I variety was evident in all the three cases. NRLN is a rare anatomical variant and routine preoperative imaging studies are not indicated. The risk of injury to the nerve is nullified by routine dissection and identifying its course along the paratracheal region. NRLN is related with absence of the brachiocephalic trunk and aberrant (mainly retroesophageal) course of the right subclavian artery which is evident on contrast-enhanced CT scan of the chest. Expensive imaging modalities are not warranted to screen a variation which is less than 1%.

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“…Recurrent laryngeal nerve injury is a big problem in the operation, which we have experienced. Therefore, the recurrent laryngeal nerve must be carefully dissected and totally exposed during thyroid surgery in order to best preserve its function [17,18]. Moreover, the thyroid surgeon must be aware of the existence of anatomical variations, which are not as rare as one may think.…”

Section: Discussionmentioning

confidence: 99%

A case of big substernal goiter resection

Song

Liao

et al. 2008

Front. Med. China

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Substernal goiter is considered to be a diagnostic differential for all anterosuperior mediastinal masses. For a substernal goiter, surgical removal is suggested when it is large in size, with a possibility for malignancy or has local compression of adjacent structures. This can be performed through the neck or by the addition of a partial or complete sternotomy if necessary. A 58-year-old Chinese man from Guangdong Province had had dry cough for a year. A subsequent CT scan in our hospital suggested ''ectopic intrathoracic thyroid''. Fine needle percutaneous mass biopsy also suggested ''ectopic intrathoracic thyroid''. We performed a standard median sternotomy to remove the mass. It measured 13 cm 6 8 cm 6 6 cm in size, and weighed 2.8 kg. The pathological diagnosis confirmed a benign thyroid adenoma. The patient had no hoarseness, dyspnea or hypocalcemia and was quickly extubated in the operating room. Recently, we encountered a big substernal goiter and had performed successful resection, which is reported here for reference.

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

Abstract: 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.

Cited by 37 publications

References 12 publications

Characteristic travelling patterns of non-recurrent laryngeal nerves

Characteristic travelling patterns of non-recurrent laryngeal nerves

Retroesophageal Right Subclavian Artery with Nonrecurrent Laryngeal Nerve: Unique Variation of Surgical Importance

A case of big substernal goiter resection

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