Incidental presence of non recurrent laryngeal nerve in our series of thyroidectomy
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20191441Keywords:
Non-recurrent laryngeal nerve, Anatomical variants of recurrent laryngeal nerve, Recurrent laryngeal nerve injuryAbstract
Background: Recurrent laryngeal nerve (RLN) injury is one of the most important and preventable complications of thyroidectomy which is the cause of post-operative iatrogenic vocal cord paralysis. The non-recurrent laryngeal nerve (NRLN), which is found in 0.25–0.99 of the patients who undergo thyroid surgery, is a rare embryologically-derived variant of the recurrent laryngeal nerve (RLN). Identification and prevention of injury to the laryngeal nerve is very important in thyroid surgery. The objective of the study was to highlight the incidence of Non-recurrent laryngeal nerve in our series of thyroidectomy cases.
Methods: In the Department of Otorhinolaryngology, Pondicherry a retrospective analysis of all the thyroid surgeries that were operated between August 2006-November 2018 for various indications on a total of 1006 patients was done with specific interest in the lookout for anatomical variant of recurrent laryngeal nerve and findings were recorded.
Results: Among all the cases, two patients with MNG who had underwent Total thyroidectomy were found to have anatomical variants of recurrent laryngeal nerve (non recurrent laryngeal nerve) intra operatively.
Conclusions: The NRLN is a rare finding and is associated to an increased risk in iatrogenic injury especially during thyroid surgeries unless thorough anatomical knowledge and cautious dissection is not done.
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References
Majid MA, Siddique MI. Major post-operative complications of thyroid surgery: Preventable or not? Bangladesh Med Res Counc Bull. 2008;34(3):99–103.
Dralle H, Lorenz K, Machens A. Verdicts on malpractice claims after thyroid surgery: emerging trends and future directions. Head Neck. 2012;34(11):1591–6.
Uludag M, Isgor A, Yetkin G, Citgez B. Anatomic variations of the non-recurrent inferior laryngeal nerve. BMJ Case Rep. 2009;2: bcr10.2008.1107.
Wang Y, Wang Z, Zhang H, Zhang P, Liang H, Dong W. Preoperative CT diagnosis of right non-recurrent inferior laryngeal nerve. Head Neck. 2011;33(2):232–8.
Stedman GW. A singular distribution of the nerves and arteries of the neck and the top of the thorax. Edinb Med Surg J. 1823;19:564–5.
Buła G, Mucha R, Paliga M, Koziołek H, Niedzielski Z, Gawrychowski J. Non-recurrent laryngeal nerve. Pol Przegl Chir. 2015;87:336–9.
Defechereux T, Albert V, Alexandre J, Bonnet P, Hamoir E, Meurisse M, The inferior non recurrent laryngeal nerve: a major surgical risk during thyroidectomy, Acta Chir Belg. 2000;100(2):62–7.
Abboud B, Aouad R, Non-recurrent inferior laryngeal nerve in thyroid surgery: report of three cases and review of the literature. J Laryngol Otol. 2004;118:139–42.
Brandon MH, Silvia S, Matthew Graves J. The non-recurrent laryngeal nerve: a meta-analysis and clinical considerations. Peer J. 2017;5:e3012.
Toniato A, Mazzarotto R, Piotto A, Bernante P, Pagetta C, Pelizzo MR. Identification of the non-recurrent laryngeal nerve during thyroid surgery:20-year experience, World J Surg. 2004;28:659–61.
Hisham AN, Sarojah A, Alvin A. Non-recurrent Laryngeal Nerve in Thyroid Surgery, Med J Malaysia. 2001;56(4):500-2.
Casal D, Pecas A¸ Sousa D, Rosa-Santos J. A non-recurrent inferior laryngeal nerve in a man undergoing thyroidectomy: a case report. J Med Case Rep. 2010;4:386.