The clinical significance of the ramification of the recurrent laryngeal nerves. A critical anatomical study

Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region

“…One example of this is the exhaustively detailed study published by Dilworth 17. Other more modern studies described the course and distribution of the laryngeal nerves without any reference to the blood supply,16–29 whereas exhaustive studies of the vascular supply11, 12 and other previously published studies have failed to consider the relationships between vessels and nerves 5–15. In our opinion, to the best of our knowledge, there was a need to define the relationships between these structures, not only at their entrance to the larynx, but also from an endoluminal perspective.…”

“…For the above‐mentioned reasons, before CO 2 laser surgery is performed, a sound knowledge of the vascular anatomy of the region is required if the risk for development of complications is to be minimized. However, in the older classical studies and the more recently published reports describing the vascular5–15 and neural16–29 supply of the larynx, no references are made to the topographical relations of the neurovascular structures from an endoscopic approach, an essential aspect when undertaking microsurgery. Therefore, the aim of this study was to describe the topographic relations of the vascular elements within the supraglottic region that could be subjected to damage during endoscopic surgery and to suggest some constant, easily recognizable endoluminal landmarks that enable their reliable localization before surgery.…”

Recurrent laryngeal nerve landmarks revisited

“…5,15,[28][29][30] In our opinion, the observed discrepancies in the reports analyzing the terminal branching of the RLN are due to the fact that some authors included collateral branches as well as RLN terminal branches. 5,15,[28][29][30] In our opinion, the observed discrepancies in the reports analyzing the terminal branching of the RLN are due to the fact that some authors included collateral branches as well as RLN terminal branches.…”

Variability of the Nerve Supply Patterns of the Human Posterior Cricoarytenoid Muscle

“…Although some authors have reported that the branch to the PCA muscle always arises in a common trunk, together with the arytenoid branch, 14–16 other authors have described it in only 8% of cases 5,6 or as a casual finding. 4,15,17–20 Our results show this type of common origin in 90.1% of the muscles studied.…”

“…This innervation has been reported as always 14,15 or as occasionally 4,5,6,16–20 arising in common with the innervation of the interarytenoid muscle. On the other hand, although some authors have considered the PCA nerve supply to be constantly formed by only one branch, 7,13,14,17 a greater number of authors have regarded it as made up of two, 18,21 three, 5,6,16 or up to nine 20 branches. When more than one branch is present, they interconnect, making the PCA nerve supply more complex.…”