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[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.
Il Giornale Di Chirurgia
|February 14, 2006
Summary
Nonrecurrent laryngeal nerves (NRRLNs) are rare, found in 0.39% of surgeries. Awareness of this anomaly, often linked to a right subclavian artery, is crucial for surgeons to prevent vocal cord paralysis during thyroid or parathyroid procedures.
Area of Science:
- Anatomy
- Surgery
- Vocal Cord Function
Background:
- Damage to the recurrent laryngeal nerve (RLN) during thyroid or parathyroid surgery is a common cause of vocal cord paralysis.
- Meticulous surgical technique and nerve identification can reduce this complication.
- Nonrecurrent RLNs (NRRLNs) are rare anatomical variations requiring surgical awareness.
Purpose of the Study:
- To determine the incidence of nonrecurrent laryngeal nerves (NRRLNs).
- To highlight the importance of recognizing NRRLNs to prevent iatrogenic vocal cord paralysis.
Main Methods:
- Retrospective review of 263 right RLN and 251 left RLN exposures over a 5-year period.
- Analysis of nerve positioning and associated anatomical anomalies.
Main Results:
- Two NRRLNs were identified, resulting in an overall incidence of 0.39% (0.76% for right-sided dissections).
- No anatomical anomalies were noted on the left side.
- The nerve anomaly was not diagnosed preoperatively in any cases.
Conclusions:
- Nonrecurrent laryngeal nerves (NRRLNs) are rare but significant surgical findings.
- NRRLNs are associated with a right subclavian artery originating from the distal aortic arch.
- Surgeons must be aware of NRRLNs to avoid accidental injury during thyroid and parathyroid surgery, thereby preventing vocal cord paralysis.