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Updated: Jun 19, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Unusual external branch of the superior laryngeal nerve: a case report
Thejodhar Pulakunta1, Bhagath Kumar Potu, Muddanna S Rao
1Department of Anatomical Sciences, St. Matthew’s University School of Medicine, P.O. Box 30992 SMB KY1-1204, Grand Cayman, Cayman Islands, BWI. thejodhar@gmail.com
Introduction:
The knowledge of the branching pattern of external branch of the superior laryngeal nerve and its relationship with the superior thyroid artery is the key point for identifying the external branch of the superior laryngeal nerve during surgeries of the neck.
Case Presentation:
During routine dissection of the left head and neck region of a 50 years old female cadaver, we observed a variation of the external branch of the superior laryngeal nerve around the superior thyroid artery. The external branch of the superior laryngeal nerve has presented one medial and three lateral branches. The medial branch was running on the surface of the inferior constrictor and pierced it; where as the lateral three branches are located laterally to the superior thyroid artery. The medial two lateral branches were piercing the substance of the thyroid gland, where as the lateral most branch was communicating with the left sympathetic chain.
Conclusion:
It is very important that surgeons carefully dissect the region of the superior pole of the thyroid gland to expose the abnormal branching pattern of external branch of the superior laryngeal nerve prior to ligation of individual thyroid vessels.
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