The recurrent laryngeal nerve: Related vascular anatomy

Abstract

This study was based on 34 recurrent laryngeal nerve dissections after arterial casting with red-colored latex. The aim was to provide specific information about the perineural microvasculature. This study established the following points: 1. a great anatomic variability does exist; 2. the laryngeal nerve is usually in relation to the posterior branch of the inferior thyroid artery; and 3. this vascular branch is sometimes replaced with a vascular network. In all cases, this microvascularization must be preserved during thyroid surgery.

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

“…Our knowledge of variations of the RLN comes from multiple studies [8][9][10][11][12], recently mentioned by Yalcin [13].…”

“…This knowledge is one of the reasons why we should not use ITA as 'the only landmark' to identify RLN. It must be kept in mind that the variability of the anatomic pattern of the ITA affects the constancy of the relation between nerve and artery [35].…”

Relation of the external branch of the superior laryngeal nerve to the superior pole of the thyroid gland: An anatomical study

“…The major concern in thyroid gland surgery is morbidity because of injury of anatomical structures (Wagner and Seiler, 1994;Moreau et al, 1998). Three important structures are necessary to preserve during thyroidectomy, namely the recurrent laryngeal nerve (RLN), the parathyroid glands, and the external branch of the superior laryngeal nerve (external laryngeal nerve or ELN) (Delbridge et al, 1992).…”

“…The complication most feared by both the patient and surgeon is damage to the RLN (Wagner and Seiler, 1994). Thus, an enormous volume of work has been done to document the surgical anatomy of the RLN, to protect the nerve during surgery (Lekacos et al, 1987;Moreau et al, 1998;Hurtado-Lopez et al, 2005), all of which including the following parameters: origin of the RLN, number of terminal divisions of the RLN, relation of the RLN to the suspensory ligament of Berry, Zuckerkandl's tuberculum, and the inferior thyroid artery (ITA).…”

Anatomic configurations of the recurrent laryngeal nerve and inferior thyroid artery

“…2 Because of the importance of this phenomenon, many researchers have investigated the anatomic confi guration between the RLN and inferior thyroid artery (ITA) in cadavers or patients and frequently described three types; the RLN was in front of or behind the ITA, or between its branches. 3,4 Yih-Huei Uen et al also investigated the relationship in 60 cases and classifi ed three types confi gurations similar to the authors. Nevertheless, we investigated the relationships in 50 specimens (100 RLNs) and found 20 different types of confi gurations.…”