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Updated: Dec 19, 2025
05:25
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
231
Anatomical Variations in Recurrent Laryngeal Nerves in Thyroid Surgery
Chuanchang Yin1, Bin Song1, Xiaoyan Wang2
1Department of Thyroid Surgery, Jingzhou No. 1 People's Hospital and First Affiliated Hospital of Yangtze University, Hubei Province, China.
Ear, Nose, & Throat Journal
|June 5, 2020
Summary
Thyroid surgery requires awareness of recurrent laryngeal nerve (RLN) variations. Understanding extralaryngeal bifurcation of RLNs helps surgeons prevent vocal cord paralysis.
Area of Science:
- Anatomy
- Surgical Procedures
Background:
- Recurrent laryngeal nerve (RLN) paralysis is a risk in thyroid surgery.
- Understanding RLN branching patterns is crucial for surgical safety.
Purpose of the Study:
- To investigate the terminal bifurcation patterns of RLNs.
- To identify variations in RLN entry into the larynx.
- To reduce the risk of vocal cord paralysis during thyroidectomy.
Main Methods:
- Dissection of RLNs in 294 patients (482 sides).
- Recording the original direction and branching of RLN trunks.
- Documenting variations including extralaryngeal bifurcations and nonrecurrent laryngeal nerves.
Main Results:
- Approximately 30.9% of RLNs showed multiple branches entering the larynx.
- Bifurcations (2 or 3 branches) were observed in 25.5% and 5.4% of cases, respectively.
- Anatomical variations like nonrecurrent laryngeal nerves occurred in 0.4% of cases.
Conclusions:
- Anatomical variations in RLN branching are common.
- Surgeons must be aware of extralaryngeal bifurcations to protect these nerves.
- A safe and successful dissection approach can prevent permanent RLN injury.
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