Recurrent laryngeal nerve (RLN) is related to ITA at lower pole of thyroid and RLN may lie either. When there is iatrogenic injury to the nerves supplying the larynx after thyroid surgery, it is a significant complication. Main component: thyroid follicles. The recurrent laryngeal nerve passes upward generally behind, but occasionally in front of, the inferior thyroid artery. 1 ). The nerve may meet the inferior thyroid artery. . Achieving a safe and effective operation on the thyroid gland is the goal of all surgeons. External Laryngeal Nerve is the most common nerve injured in ligation of superior thyroid artery. See also: artery. Anatomic variations of a recurrent laryngeal nerve (RLN) may threaten the safety of thyroid surgery and so a complete knowledge of RLN anatomy, including all of its variations, must be mandatory for thyroid surgeons.

In the present study, we aimed to define and classify in detail all of the possible relationships between the two anatomic structures and their branches. Previous article In 39.1% of cases the recurrent laryngeal nerve was located between the branches of the inferior thyroid artery, in 39.1% of cases deeper than the artery, and in 10.9% of cases more . To ensure safety of recurrent laryngeal nerve during thyroid surgery, surgeons should have extensive knowledge of position of recurrent laryngeal nerve and its relationship with inferior thyroid artery. The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) is volatile ( Fig. Among them, nonrecurrent inferior laryngeal nerve (NRILN) is commonly caused by an embryologic anomaly of the aortic arch, such as an aberrant right subclavian artery. The main postoperative complications are recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism [1-3]. Password. Comprehensive database searches were conducted, followed by judgment of eligibility, assessment, and extraction of data concerning the RLN/ITA relationship. The book is visually oriented with color illustrations and photomicrographs embracing all aspects of recurrent laryngeal nerve anatomy including branching patterns, relationship of the nerve and the inferior thyroid artery and the non-recurrent recurrent laryngeal nerve.

Langenbecks Arch Surg 2008;393:681-5. The aim of this study is to investigate the traveling patterns of NRLNs and its relationships to inferior thyroid arteries (ITAs). The inferior thyroid artery runs up through your neck and throat. For all head and neck surgeons to perform safe surgery on thyroid, it is necessary to have sound anatomical knowledge of these variable relationships between recurrent laryngeal nerve and inferior thyroid artery. Enter the email address you signed up with and we'll email you a reset link. The external branch of superior laryngeal nerve courses over the external surface of the thyropharyngeal part and pierces it on its way to the larynx. Results (1 . The relationship between the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA) is highly variable and traceable back to embryological life. A new classification system for recurrent laryngeal nerve anatomy is proposed. Study the relationship of the recurrent laryngeal nerve with the inferior thyroid artery and to the thyroid gland on both sides. In the present study, we aimed to define and classify in detail all of the possible relationships between the two anatomic structures and their branches. One crucial known variant is the lack of the recurrent laryngeal nerve being "recurrent" around the subclavian or aorta and instead arising from the vagal truck in the neck and traversing with the inferior thyroid artery to the larynx. This makes it vulnerable to injury during surgery that involves ligating the inferior thyroid artery, such as excision of the lower pole of the thyroid gland. ; it was found in this position in 47.3% of male corpses and 42.8% of female ones. The inferior laryngeal nerve (ILN) is the most important structure in thyroid operations. The non-recurrent inferior laryngeal nerve (arrow), with its shiny nerve sheath, branched from the vagus nerve under the right common carotid artery (CCA), and entered the . or reset password. The relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) is an important and helpful landmark for isolating the RLN and its branches during surgery. Synonyms: Inferior laryngeal nerve. The recurrent laryngeal nerve can also ascend anterior (approximately 32.5%) to or in between the branches of the inferior thyroid artery (approximately 6.5%). Recurrent laryngeal nerve is in close association with Inferior thyroid artery. Achieving a safe and effective operation on the thyroid gland is the goal of all surgeons. This required excision of the lower pole (left lobe) of the gland and ligation of the artery supplying that region. 2008;393(5):681-5. Langenbecks Arch Surg. Objectives: The relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) is an important and helpful landmark for isolating the RLN and its branches during surgery. Introduction. Galen's anastomosis is between Recurrent laryngeal nerve and internal laryngeal nerve. The non-recurrent inferior laryngeal nerve (NRLN) represents a risk factor for nerve injury during thyroid surgery. Our first case we noted a non recurrent laryngeal type I in the right side. Complete anatomic knowledge including all variations of the inferior laryngeal nerve (ILN) is mandatory for thyroid surgeon. In fact, the RLN can pass in front of, behind, or between branches of the right inferior thyroid artery. Often during thyroidectomies, surgeons leave one parathyroid gland as not to cause the patient to become hypocalcemic . CAS Google Scholar Moreau S, De Rugy MG, Babin E, Salame E, Delmas P, Valdazo A. The relationship between the RLN and the ITA is quite variable. The recurrent laryngeal nerve may also vary in its relationship with the inferior thyroid artery as the nerve approaches the inferior pole of the thyroid gland. Langenbeck's archives of surgery/Deutsche Gesellschaft fur Chirurgie 393, 681-685 (2008). Injury to the vagus nerve or the recurrent laryngeal nerve can be caused by retractors or by direct trauma from the use of forceps, electrocauterization, or the application of arterial clamps. The third surface of the thyroid is known as the posterolateral surface. . If the nerve was branched at the proximal of ITA, it was dissected to the point where it branched proximally.

This is the entry point into the larynx under the inferior horn of the thyroid cartilage. . The inferior thyroid artery (Latin: arteria thyreoidea inferior) is the largest branch of the thyrocervical trunk. Campos BA, Henriques PRB. The different terms and opinions about the twigs of the truncus thyreocervicalis and the thyroid axis are discussed. In most people, the recurrent laryngeal nerve is related to the inferior thyroid artery's posterior branch, but a vascular network can replace this. Original Article from The New England Journal of Medicine The Relations of the Inferior Thyroid Artery and the Recurrent Laryngeal Nerve The recurrent laryngeal nerve and the inferior thyroid artery--anatomical variations during surgery Abstract Background and aims: Recognition of variations of the inferior laryngeal nerve is essential. We aimed to investigate the relationship of the inferior laryngeal nerve with the inferior thyroid artery. In both sexes, the RLN lay more frequently between branches of the ITA. The Anatomical Relationship of Inferior Thyroid Artery and Recurrent Laryngeal Nerve: A Review of the Literature and Its Clinical Importance. Lobules of thyroid gland. Both nerves are at risk during thyroid surgery. Purpose The aim of this study was to provide some important information about the morphology and topography of the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA), which significantly helps localize and protect the RLN in neck surgery, especially in thyroid surgery. In the present study, we aimed to define and classify in detail all of the possible relationships between the two anatomic structures and their branches. INTRODUCTION Thyroidectomy is one of the most frequently performed operations in iodine deficient areas and injury to recurrent laryngeal nerve(s) remains the most serious concern during this surgery especially in malignant cases and redo surgeries. 6. The inferior parathyroid gland is usually identified within 1 cm of this junction. Since most cysts are located at the posterior, inferior position of thyroid glands near the intersection between inferior thyroid artery and recurrent laryngeal nerve, the nerve should be well protected.15 Although laparoscopic thyroid cystectomy has been widely applied, it is assigned to a traumatic surgery rather than a minimally invasive one owing to long surgical time, large surgical field . Surgical dissection of 200 ILNs was performed on 100 cases. The aim of this work is to determine the topographic relationship of the RLN with the inferior thyroid artery (ITA), the tubercle of Zuckerkandl (TZ), and the ligament of Berry (LB) in a Kenyan population. inferior thyroid artery superiorly and recurrent laryngeal nerve as the third side. Nerve supply of the mucosa of larynx is by Internal and recurrent laryngeal nerve. At the inferior pole of the thyroid gland, the recurrent laryngeal nerve is closely related to the inferior thyroid artery. The right recurrent laryngeal nerve is more susceptible to damage during thyroid surgery because it is close to the bifurcation of the right inferior thyroid artery, variably passing in front of, behind, or between the branches. PMID: 3803858

Background . We had 11 patients showing NRLNs on the right side who underwent thyroidectomies. The recurrent laryngeal nerve, a branch of CN X courses with the inferior thyroid artery, while dissecting the ITA insult to the recurrent laryngeal nerve will cause the patient to go hoarse as this nerve innervates the larynx. The laryngeal nerves have various anatomical variants. The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. Recurrent laryngeal nerve palsy (RLNP) is a long recognized and potentially catastrophic complication of thyroid surgery. 7. Thyroidectomy is one of the most frequent operations performed in iodine-deficient regions. In rare cases, this nerve does not loop under the right subclavian artery or the aortic arch. . . Keywords: Inferior thyroid artery, Recurrent laryngeal nerve, Thyroid surgery. Recurrent laryngeal nerve (RLN) is related to. The inferior thyroid artery, traditionally used as a guide in identifying the recurrent laryngeal nerve, is not wholly reliable because of two factors which affect the constancy of the relation between nerve and artery. Conclusions: The anatomical relationship between Recurrent Laryngeal Nerve RLN and Inferior Thyroid Artery ITA is highly variable. : 820-1 Similarly, thermal injury can occur with the use of radio frequency ablation to remove thyroid nodules. Need an account? The limits of this technique . Laryngeal Nerve Palsy or Paralysis . The tissue between the carotid artery and the trachea was dissected gently parallel to the direction of the nerve until the nerve is identified visually and . Simon's triangle The recurrent laryngeal nerve passes upward generally behind, but occasionally in front of, the inferior thyroid artery. of the recurrent laryngeal nerve to the inferior thyroid artery:a meta-analysis and surgical implications.

The recurrent laryngeal nerve and the inferior thyroid artery-anatomical variations during surgery.