Extralaryngeal variants of the location of the recurrent laryngeal nerve. Clinical observation in thyroid surgery

Abstract

The recurrent laryngeal nerve can have a variety of options in extralaryngeal position, which often changes the technique of surgical intervention in each specific case. Below there are two clinical observations of the non-recurrent laryngeal nerve and additional collateral anastomosingstructures of the recurrent laryngeal nerve. The non-recurrent laryngeal nerve, according to the recent research, is found in the general population somewhat more often (up to 4.8%) than the practicing surgeon may suggest. The identification of a non-recurrent laryngeal nerve before surgery is an important object of research. According to many authors, the cord palsy in the non-recurrent laryngeal nerve increases many times compared with the recurrent laryngeal nerve. The functional and clinical significance of the anastomosing structures of the recurrent laryngeal nerve is still unknown. To visualize them during surgery is a rare phenomenon, which ultimately leads to their damage. Thus, an alternative to the theory of traction damage of the recurrent laryngeal nerve is the damage to its non-standard anatomical variants and anastomosing structures. Taking into account that such an option of extralaryngeal location of the recurrent laryngeal nerve is so rare, we consider it appropriate to share our own experience.

Keywords

• non-recurrent laryngeal nerve
• galen’s anastomosis
• sympathetic-inferior laryngeal nerve anastomotic branch
• case report