Related Experiment Video
Updated: Aug 11, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
[Non recurrent laryngeal nerve. Personal experience]
C Sciumè1, G Geraci, F Pisello
1Sezione di Chirurgia Generale ad Indirizzo Toracico, Università degli Studi di Palermo, AOUP Paolo Giaccone, Palermo.
Purpose:
Damage to the recurrent laryngeal nerve (RLN) during thyroid or parathyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the RLNs and meticulous surgical technique can significantly decrease the incidence of this complication. Nonrecurrent RLNs (NRRLNs) are exceedingly rare. Surgeons need to be aware of their position to avoid injuries.
Patient And Methods:
A retrospective review of 263 right RLN exposures (and 251 left RNL) over a 5-year period was performed.
Results:
Two NRRLNs were encountered, for an incidence of 0.39% (0.76% only for right dissection), without anatomic anomalies on the left side. The nerve anomaly was never preoperatively diagnosed.
Conclusion:
NRRLNs are rare and is associated with a right subclavian artery arising from distal aortic arch. Awareness of their existence and correct surgical technique will prevent the surgeon from accidentally lesion of NRRLN one if it is encountered during thyroid or parathyroid surgery.
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