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Related Experiment Video

Updated: Jul 11, 2025

Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
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Variations in Recurrent Laryngeal Nerve in Thyroidectomy.

Pankaj Kumar1, Moudipa Chatterjee1, Ajay Gupta1

  • 1Dept. of ENT, Head and Neck surgery, Dr. Baba Saheb Ambedkar Medical College and Hospital, Bhagwan Mahavir Marg, Sector 6, Rohini, Delhi India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|November 17, 2023
PubMed
Summary

This study examined Recurrent Laryngeal Nerve (RLN) anatomy during thyroid surgery. The inferior thyroid artery and tracheo-esophageal groove proved reliable landmarks for identifying the RLN.

Keywords:
Inferior thyroid arteryRecurrent laryngeal nerveThyroidectomyVocal cord palsy

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Area of Science:

  • Anatomy
  • Surgical Procedures
  • Nerve Variations

Background:

  • The Recurrent Laryngeal Nerve (RLN) is crucial for voice function.
  • Variations in RLN anatomy can complicate thyroid surgery and increase the risk of nerve injury.
  • Accurate identification of the RLN is paramount for preserving vocal cord function during thyroidectomy.

Purpose of the Study:

  • To identify and evaluate anatomical variations and the course of the Recurrent Laryngeal Nerve (RLN).
  • To assess the reliability of landmarks such as the inferior thyroid artery (ITA) and tracheo-esophageal groove for RLN identification.
  • To document the frequency of RLN variations in patients undergoing primary thyroid surgery.

Main Methods:

  • A retrospective study of 52 patients undergoing primary thyroid surgery over one year.
  • Detailed recording of RLN anatomy and its relationship to surrounding structures during surgery (56 sides operated).
  • Analysis of RLN course relative to the inferior thyroid artery and tracheo-esophageal groove.

Main Results:

  • The RLN was identified as a single trunk in 83.9% of cases.
  • Extra-laryngeal branches were observed in 10.7% of cases; no non-recurrent laryngeal nerves were found.
  • The RLN passed deep to the ITA in 82% of cases and within the tracheo-esophageal groove in 75.9% of cases.

Conclusions:

  • Variations in RLN anatomy were found to be infrequent in this study, potentially due to the sample size.
  • The inferior thyroid artery and tracheo-esophageal groove are reliable anatomical landmarks for tracking the RLN during thyroid surgery.
  • Understanding RLN variations and utilizing consistent landmarks can aid surgeons in preventing nerve injury.