Dual Vagus Nerve: a Rare Anatomical Entity

Duplicate cranial nerves are fundamentally rare anatomical variants. Few case reports have documented cranial nerve duplication. Proper understanding of the anatomy is important to prevent iatrogenic injury during any surgical procedure. We present a case report of duplicate vagus nerves identical in size and thickness identified during neck dissection procedure. A 44-year-old gentleman diagnosed with Squamous Cell Carcinoma of Right Parotid Gland underwent Total Parotidectomy with Elective Neck Dissection. During carotid sheath microdissection, two parallel nerve tracts were identified. The two nerves were identical in size and width. Proximal dissection confirmed that the two nerves were independent of one another and neither was a branching segment. This is the one of the few reported cases of duplicate vagus nerves identified. The authors would like to highlight the rare anatomical variant of vagus nerve and emphasize on knowledge of proper surgical anatomy to prevent inadvertent injury to cranial nerve and any vital structures during surgical procedure.