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The recurrent laryngeal nerve

J E Skandalakis, C Droulias, N Harlaftis

    The American Surgeon
    |September 1, 1976
    PubMed
    Summary
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    Identifying the recurrent laryngeal nerve during thyroidectomy is crucial due to anatomical variations. Visual identification is sufficient, and the nerve is not exceptionally delicate, minimizing risks of vocal cord injury.

    Area of Science:

    • Otolaryngology
    • Surgical Anatomy
    • Endocrinology

    Background:

    • Thyroidectomy necessitates careful identification of the recurrent laryngeal nerve (RLN) to prevent injury.
    • Anatomical variations and non-recurrent courses of the RLN present surgical challenges.
    • Understanding RLN anatomy is vital for preserving vocal function post-thyroidectomy.

    Purpose of the Study:

    • To emphasize the importance of visual identification of the RLN during thyroidectomy.
    • To clarify that the RLN is not more delicate than other nerves, reducing apprehension in surgeons.
    • To outline the consequences of unilateral and bilateral RLN injury.

    Main Methods:

    • Review of anatomical variations of the RLN.
    • Surgical observation during thyroidectomy procedures.

    Related Experiment Videos

  • Analysis of patient outcomes following potential RLN injury.

    • Main Results:

    • Visual identification of the RLN without excessive manipulation is deemed sufficient.
    • Unilateral RLN injury can cause temporary hoarseness and mild exertional airway restriction.
    • Bilateral RLN injury may lead to initial voice loss, followed by respiratory distress during exertion.

    Conclusions:

    • Visual identification is the primary method for RLN safety during thyroidectomy.
    • The RLN's fragility is comparable to similar nerves, and careful handling prevents injury.
    • Awareness of potential vocal and respiratory complications guides patient management.