Nonrecurrent laryngeal nerves and their clinical significance

Friedman, Michael; Toriumi, Dean M.; Grybauskas, Vytenis; Katz, Arthur

doi:10.1288/00005537-198601000-00016

Cited by 28 publications

(15 citation statements)

References 16 publications

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“…The importance of the NRLN lies in its vulnerability during the thyroid surgery (Riddel, 1956;Friedman et al, 1986). It is extremely helpful for surgeons to recognize a NRLN pre-operatively.…”

Section: Discussionmentioning

confidence: 99%

Importance of pre-operative recognition of the nonrecurrent laryngeal nerve

et al. 1994

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The nonrecurrent laryngeal nerve is vulnerable during thyroid surgery. Pre-operative recognition of this nerve allows surgeons to avoid injuring the nerve. This anomaly depends upon the aortic arch anomaly and, therefore, in some cases, surgeons are able to predict the presence of this nerve pre-operatively by chest X-ray or barium swallow. Two patients with nonrecurrent laryngeal nerve are reported, one of whom, a 48-year-old man, had an abnormal shadow of the aortic arch, which led to confirmation of a right aberrant subclavian artery. Barium swallow plays a decisive role in the diagnosis of nonrecurrent laryngeal nerve, and this test is mandatory in patients who complain of difficulty in swallowing.

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Section: Discussionmentioning

confidence: 99%

Importance of pre-operative recognition of the nonrecurrent laryngeal nerve

et al. 1994

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“…Außerdem scheint der NLINR aufgrund seines kurzstreckigen Verlaufes und der hieraus resultierenden geringen Mobilität für Traktionsschäden durch Volumenvermehrung der anliegenden Schilddrüse oder Nebenschilddrüsen besonders empfänglich zu sein, was sich motorisch in einer Phonationsschwäche, sensorisch in Globusgefühl oder Hustenreiz äußern kann [23]. Lässt sich duplexsonographisch rechtsseitig ein unauffälliger Truncus brachiocephalicus nachweisen, ist die Gefäß-anomalie ausgeschlossen (s. unten).…”

Section: Nervus Laryngeus Inferior Non-recurrens (Nlinr) Rechtsseitigunclassified

Verlaufsvariet�ten des Nervus laryngeus inferior

Mangold

2004

Der Chirurg

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Because of multiple variations in course, the inferior laryngeal nerve shows a great variety of topographic relations to adjacent cervical structures. It may recur in the tracheoesophageal groove or anteriorly or posteriorly to it. It can pass under, over, or through the ramifications of the inferior thyroid artery. If Zuckerkandl's tubercle is enlarged, the nerve may be luxated. It is firmly fixed to the ligament of Berry by tight adhesions. Before entering the larynx, the nerve may show multiple ramifications. It may also recur around the inferior thyroid or vertebral artery. On the right, a nonrecurrent nerve is found in 0.6-0.8% of individuals, always in coincidence with a "lusorian" artery. Three course variations can be distinguished: descending (type I), horizontal (II), and ascending (III). A nonrecurrent nerve on the left is extremely rare, as it can only be found as a combination anomaly of a right-sided lusorian artery with situs inversus viscerum. The divided inferior laryngeal nerve shows recurrent and nonrecurrent ramifications. A nonrecurrent inferior laryngeal nerve can be indirectly ruled out preoperatively by demonstration of a normally developed brachiocephalic trunk via colour-coded duplex ultrasound.

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“…The incidence of non-RLNs is much greater on the right side than on the left side, and varies from 0.4 to 2.4 per cent. [5][6][7] Berlin 8 was the first to report finding a non-RLN on the left side in 1935. Left-sided nonRLNs are extremely rare, only occurring in cases of situs inversus combined with an aberrant left subclavian artery and a right-sided ligamentum arteriosum; an incidence of 0.04 per cent has been reported.…”

Section: Introductionmentioning

confidence: 99%