1999
DOI: 10.1053/hn.1999.v120.a84675
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The Anomaly of Nonrecurrent Laryngeal Nerve: Identification and Management

Abstract: There is no greater nemesis for the thyroid surgeon than difficulty in localizing the recurrent laryngeal nerve (RLN). An unusual but important cause of this problem is the nonrecurrent laryngeal nerve (NRLN). The NRLN is vulnerable during thyroid surgery, with nerve damage potentially resulting in permanent vocal cord paralysis.The NRLN arises on the right side of the neck and is associated with malformation of the aortic arch. Preoperative chest x-ray films, therefore, are a valuable adjunct in identifying p… Show more

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Cited by 31 publications
(17 citation statements)
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“…According to the frequency of ILN palsies varying between 0.5% and 2.0% in the most series and the frequency of a NRILN of about 0.5%, identification of this atypical nerve course might be an important factor in minimizing the frequency of nerve palsies. Since a non-recurrent course of the ILN is always associated with a lusorial artery [1,14], some authors discussed angiography of the aortic arch [2,4,5] or a barium swallow test [14] as an indicator for a NRILN. Another principle of IONS of the ILN using a transtracheal stimulating tube allowing a continuous neuromonitoring has been described by Lamadé et al [9].…”
Section: Discussionmentioning
confidence: 99%
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“…According to the frequency of ILN palsies varying between 0.5% and 2.0% in the most series and the frequency of a NRILN of about 0.5%, identification of this atypical nerve course might be an important factor in minimizing the frequency of nerve palsies. Since a non-recurrent course of the ILN is always associated with a lusorial artery [1,14], some authors discussed angiography of the aortic arch [2,4,5] or a barium swallow test [14] as an indicator for a NRILN. Another principle of IONS of the ILN using a transtracheal stimulating tube allowing a continuous neuromonitoring has been described by Lamadé et al [9].…”
Section: Discussionmentioning
confidence: 99%
“…A NRILN is always associated with a lusorial artery [2,4,7]. Several cases and a few series of the occurrence of the NRILN have been reported [3,5,6,7,11,12,13,17]. With regard to Soustelle et al and Avisse et al one may classify the NRILN into type I with a horizontal course and type II with a more ascending route [2,18].…”
mentioning
confidence: 99%
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“…Anhand vergleichsweise geringer Fallzahlen (9 resp. 16) werden 2 charakteristische Verläufe ausgewiesen, wobei ein Typ I mit Abgang auf Höhe der Articulatio cricothyreoidea von einem Typ II mit Abgang auf Höhe der Arteria thyreoidea inferior unterschieden wird [11,12,24,43,44,58,60,67]. Eine weitere Diversifizierung und Subtypisierung einer solchen, ohnehin sehr seltenen anatomischen Normvariante erscheint prä-tentiös.…”
Section: Klassifikationunclassified
“…Right subclavian artery in these cases often courses behind the oesophagus, the incidence of which is reported to be around 0.5%-2% (Campbell et al, 1991, Casal et al, 2010, and Toniato et al, 2004. It is also important to note that a small proportion of these patients with retro-oesophageal subclavian artery (with normal-sized thyroid gland) will complain of symptoms of dysphagia (Cannon, 1999 andCasal et al, 2010). Therefore, clinicians will also need to counsel their patients appropriately in regard to the possibility of persistent dysphagic symptom amongst patients with concurrent retro-oesophageal subclavian artery and multinodular goitre.…”
Section: Discussionmentioning
confidence: 97%