Nonrecurrent laryngeal nerve during carotid artery surgery: Case report and literature review

Coady, Michael A.; Adler, Felix; Davila, Javier J.; Gahtan, Vivian

doi:10.1067/mva.2000.105680

Cited by 47 publications

(56 citation statements)

References 8 publications

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“…4a, b ▲ Weitere Normvarianten des NLINR mit a Abgang zweier separater Äste und b frühzeitiger Ramifikation Abb. 5 ▲ a Linksseitiger NLINR mit deszendierendem Verlauf (Typ I) bei Situs inversus viscerum mit linksversorgender Arteria lusoria und b linksseitiger NLID mit hohem Abgang und Verlauf vor der karotidojugulären Achse [14] Gefäßanomalie handelt sich am ehesten um einen NLID [62].…”

Section: Der Chirurg 2 · 2004 | 191unclassified

“…Variante eine weiter kranial gelegene Abzweigung aus dem Nervus vagus vorliegen kann, die zu einem schräg absteigenden Verlauf des nichtrekurrierenden Nerven führt [8,11,14,21,27,47,58].Lässt sich der Nerv also bei Resektionseingriffen an der Schilddrüse auf Höhe oder distal der Articulatio cricothyreoidea nicht darstellen, so muss weiter kranial gefahndet werden und zwar in zunehmend nach laterokranial aszendierender Präparationsrichtung.Eine besondere Gefährdung besteht bei der Präparati-on im Trigonum caroticum, insbesondere im Rahmen der desobliterierenden Karotischirurgie ( [14], eigener Fall).…”

Section: Klassifikationunclassified

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Verlaufsvariet�ten des Nervus laryngeus inferior

Mangold

2004

Der Chirurg

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Because of multiple variations in course, the inferior laryngeal nerve shows a great variety of topographic relations to adjacent cervical structures. It may recur in the tracheoesophageal groove or anteriorly or posteriorly to it. It can pass under, over, or through the ramifications of the inferior thyroid artery. If Zuckerkandl's tubercle is enlarged, the nerve may be luxated. It is firmly fixed to the ligament of Berry by tight adhesions. Before entering the larynx, the nerve may show multiple ramifications. It may also recur around the inferior thyroid or vertebral artery. On the right, a nonrecurrent nerve is found in 0.6-0.8% of individuals, always in coincidence with a "lusorian" artery. Three course variations can be distinguished: descending (type I), horizontal (II), and ascending (III). A nonrecurrent nerve on the left is extremely rare, as it can only be found as a combination anomaly of a right-sided lusorian artery with situs inversus viscerum. The divided inferior laryngeal nerve shows recurrent and nonrecurrent ramifications. A nonrecurrent inferior laryngeal nerve can be indirectly ruled out preoperatively by demonstration of a normally developed brachiocephalic trunk via colour-coded duplex ultrasound.

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Section: Der Chirurg 2 · 2004 | 191unclassified

Section: Klassifikationunclassified

Verlaufsvariet�ten des Nervus laryngeus inferior

Mangold

2004

Der Chirurg

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“…In 4 of these patients, the NRILN was accompanied by an ipsilateral recurrent ILN (RILN). The authors of the remaining report did not describe a coexisting RILN, and they reported the absence of situs inversus and right aortic arch (Coady et al 2000). There is no appropriate embryological and anatomical reason to explain existence of NRILN without vascular anomaly.…”

Section: Discussionmentioning

confidence: 98%

“…She experienced no symptoms related to the previous thyroid operation such as hoarseness, and no symptoms related to an aberrant subclavian artery such as dysphagia, cough, stridor, or thoracic pain before the first thyroid operation. Five cases of NRILN without vascular anomaly have been reported (Henry et al 1988;Kato et al 1996;Coady et al 2000). In 4 of these patients, the NRILN was accompanied by an ipsilateral recurrent ILN (RILN).…”

Section: Discussionmentioning

confidence: 99%

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Nonrecurrent Inferior Laryngeal Nerve Without Vascular Anomaly as a Genuine Entity

Tateda

Hasegawa

Sagai

et al. 2008

Tohoku J. Exp. Med.

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Inferior laryngeal nerve (ILN), which usually arises from vagus nerve, runs recurrent course and is called recurrent ILN (RILN). Intimate knowledge of normal and anatomic variants of the ILN reduces the risk of nerve injury and vocal cord paralysis in thyroid and parathyroid surgery. The nonrecurrent ILN (NRILN) is a rare nerve anomaly that is associated with a right aberrant subclavian artery. We encountered 2 patients with NRILN during thyroid surgery. Patient 1, a 57-year-old woman, had mediastinal thyroid tumor without vascular anomaly. Patient 2, a 47-year-old woman with a history of esophageal foreign body (fish bone), was suspected to have NRILN with vascular anomaly before surgery, as judged by preoperative enhanced CT. In the patient 1, we verified laryngeal mobility function of the NRILN by nerve stimulation, and confirmed the absence of RILN in usual recurrent course. The findings in the patient 1 indicate that NRILN without subclavian artery anomaly is a genuine entity. In both patients we performed thyroid surgery safely and fast by expectation and identification of NRILN by use of nerve stimulator. In conclusion, we confirm the existence of NRILN without vascular anomaly and show effectiveness of preoperative enhanced CT and valuable use of nerve stimulator for nerve preservation in the patients with NRILN.Nonrecurrent inferior laryngeal nerve; aberrant subclavian artery; esophageal foreign body; nerve stimulator; CT. Inferior laryngeal nerve (ILN) palsy is a major problem in thyroid and parathyroid surgery. Intimate knowledge of normal and anatomic variants of the ILN reduces the risk of nerve injury and vocal cord paralysis. It is generally accepted that the nonrecurrent inferior laryngeal nerve (NRILN) is a well-known but relatively rare anatomic variant. The prevalence of NRILN is less than 1% based on surgical reports (Henry et al. 1988;Proye et al. 1991;Avisse et al. 1998;Devèze et al. 2003; Toniate et al. 2004) and 1-2% based on anatomical reports (Avisse et al. 1998). The NRILN usually arises on the right side of the neck and is associated with malformation of the aortic arch and aberrant subclavian artery. In NRILN, there are several unsolved problems,

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Radiology Quiz Case 2—Diagnosis

2004

Arch Otolaryngol Head Neck Surg

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Nonrecurrent laryngeal nerve during carotid artery surgery: Case report and literature review

Cited by 47 publications

References 8 publications

Verlaufsvariet�ten des Nervus laryngeus inferior

Verlaufsvariet�ten des Nervus laryngeus inferior

Nonrecurrent Inferior Laryngeal Nerve Without Vascular Anomaly as a Genuine Entity

Radiology Quiz Case 2—Diagnosis

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