Related Experiment Video
Updated: Apr 19, 2026
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Efficient, effective, safe procedure to identify nonrecurrent inferior laryngeal nerve during thyroid surgery
Akihito Watanabe1, Masanobu Taniguchi1, Yuki Kimura1
1Department of Otolaryngology - Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan.
Background:
The nonrecurrent inferior laryngeal nerve (NRILN) is always associated with the aberrant subclavian artery. CT images can detect this vascular anomaly, which predicts an NRILN. The purpose of this study was to report our procedure to identify the NRILN in patients with the aberrant subclavian artery.
Methods:
Four of 730 patients undergoing thyroid operation in our hospital were preoperatively diagnosed with aberrant subclavian artery by CT of the neck. To avoid vocal cord paralysis, we approached the vagal nerve first before dissecting the paratracheal region to discover the separation point of the NRILN from the vagal nerve.
Results:
The NRILN was identified without difficulty in all 4 patients. No patients showed vocal cord paralysis.
Conclusion:
Approaching the vagal nerve first before dissecting the paratracheal region is an efficient, effective, and safe procedure to identify an NRILN in patients who are preoperatively diagnosed as having the aberrant subclavian artery.
