Non-recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review

Emmanouil Bakalinis, Ioannis Makris, Theano Demesticha, Georgios Tsakotos, Panagiotis Skandalakis, Dimitrios Filippou

Abstract


Objective. The purpose of this paper is to review the current data on the coexistence of non-recurrent laryngeal nerve (RLN) and vascular variations.

Methods. A systematic literature search was conducted on MEDLINE for case reports, original articles and reviews regarding the presence of non-RLN and coexisting vascular variants.

Results. From the literature search, 104 cases of non-RLN with confirmed vascular variants were reported. More specifically, 97.7% (n=101) of cases involved a right and 2.3% (n=3) a left non-RLN. The most common concurrent vascular variant reported with a right non-RLN was an aberrant right subclavian artery (97%; n=98). One case report (0.9%) of an intrathyroidal right common carotid artery was noted and 2 cases (1.9%) were associated with normal vascular anatomy. Furthermore, all 3 cases of a left non-RLN were associated with a right aortic arch, while 2 of them were also accompanied with situs inversus.

Conclusions. The presence of vascular variations of the great vessels must prompt the surgeon to search for a non-RLN. Intraoperative neuromonitoring increases the detection rate of non-RLN. Further research is required to determine anatomic landmarks for the perioperative identification of a non-RLN, allowing its protection from potential injury.


Keywords


Thyroidectomy; Recurrent Laryngeal Nerve; Variant; Aberrant Right Subclavian Artery

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DOI: http://dx.doi.org/10.5644/ama2006-124.230

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