Nonrecurrent laryngeal nerve in thyroid surgery: Frequency, anatomical variations according to a new classification and surgery consideration

Head Neck. 2019 Sep;41(9):2969-2975. doi: 10.1002/hed.25771. Epub 2019 Apr 17.

Abstract

Background: The nonrecurrent laryngeal nerve (NRLN) is a rare embryologically derived variant of the RLN. We aimed to identify the proportion of NRLN (during thyroidectomy), classify clinical NRLN types, and recommend some surgical considerations.

Method: In this prospective study, from May 2017 to September 2018, our hospital carried out 2158 thyroid operations. We reported the NRLN rate and distinguished NRLN into four types.

Results: Overall, NRLN had an incidence rate of 0.74% (16 out of 2158 total thyroid surgeries). We did not detect any patient with left-sided NRLN. The traveling patterns of the nerves could be classified as descending (12.5%), vertical (25%), ascending (37.5%), or V-shaped (25%).

Conclusion: The NRLN is a rare variation of the RLN. From our experience, we recommend the guidelines will help surgeons to avoid NRLN injury.

Keywords: laryngeal nerve; nonrecurrent laryngeal nerve; thyroid surgery; thyroidectomy.

MeSH terms

  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Intraoperative Complications / prevention & control
  • Intraoperative Period
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrent Laryngeal Nerve / abnormalities*
  • Recurrent Laryngeal Nerve Injuries / prevention & control
  • Thyroidectomy*