Gender, race, and electrophysiologic characteristics of the branched recurrent laryngeal nerve

Abstract

African American patients have a higher rate of RLN bifurcation compared to Caucasian patients but no statistically significant difference in distance from NEP. Female patients tend to have longer branching variants of bifid RLNs. RLN motor fibers reside primarily in the anterior branch but may occur in the posterior branch.

Location of motor fibers within branches of the recurrent laryngeal nerve with extralaryngeal terminal bifurcation; Functional identification by intraoperative neuromonitoring

“…The rate of 33% (61 of 185 RLNs) of bifurcated nerves among exposed RLNs in this study is comparable with that of previous reports of 31-43%. [10][11][12][13][14] We also observed that bifurcation occurred adjacent to the ITA and distally to the nerve-artery crossing in 87% of RLNs. Besides the common occurrence of ETB, variable locations of division points along the cervical course of the nerve create many combinations that complicate the dissection and exposure of the nerve.…”

“…According to our results, the anterior branches of all bifurcated nerves contain motor fibers, in accordance with the findings of previous reports confirming that 100% of anterior branches are pathways of motor activity. 1,10,11,14,16,17 After electrophysiologic stimulation, our results showed that the vast majority of posterior branches were only sensory in function with negative signals recorded on IONM. We recorded motor activity in posterior branches in only 11.5% of the bifid RLNs.…”

Extralaryngeal division of the recurrent laryngeal nerve: A common and asymmetric anatomical variant

“…They found similar rates between the right and left sides in their subsequent extensive studies and stated that the observations obtained from more extensive series may be more reliable (12). The branching rates were found to be similar between the right and left sides in other studies (9,13,14,18).…”

“…The risk of developing nerve paralysis is higher in extralaryngeal branching of the RLN (7,8). The nerve may be vulnerable to compression, traction, and transection due to the diminished caliber of the nerve due to the branching (9). A wide range of branching rates have been reported in studies on branching of the RLN (4).…”

A review of methods for the preservation of laryngeal nerves during thyroidectomy

“…İONM ça-lışmaları, RLS ön dalının her zaman motor fonksiyona sahip olduğunu, buna karşın %1.14-28.2 oranında arka dalın da motor fonksiyon içerdiği göstermiştir. [61][62][63][64] En yüksek oran (%28.2) Cho ve ark. [63] tarafından bildirilmiş olmakla beraber bu seride dallanma oranı düşüktür (%14.5).…”