Variation of recurrent laryngeal nerve found in thyroid surgery
10.3760/cma.j.issn.1007-631X.2013.06.008
- VernacularTitle:甲状腺手术中喉返神经变异的临床研究
- Author:
Pinyi ZHANG
;
Bin ZHANG
;
Yao LIU
;
Weifeng ZHANG
- Publication Type:Journal Article
- Keywords:
Thyroid diseases;
Thyroidectomy;
Recurrent laryngeal nerve;
Anatomic variation
- From:
Chinese Journal of General Surgery
2013;(6):431-435
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the anatomic variations of recurrent laryngeal nerve (RLN during thyroid surgery and to investigate the technical key points for identification and preservation of the nerve.Methods Clinical data of 1548 consecutive patients undergoing thyroid operation with intraoperative routine exposure of RLN from June 2010 to June 2012 was retrospectively analyzed.Results In this series,2620 RLNs at risk were clearly exposed and identified during a total of 1548 thyroid operations,wherein complete dissection was performed on 1886 nerves.Injury occurred in 11 of 2620 (0.42％) nerves.Through the analysis of all 2620 RLNs,conditional variations were found in 64 nerves.Of 1886 RLNs that were completely dissected,421 (22.3％)nerves presented with natural variations of six patterns,including morphological branching variation in 126 (6.68％) nerves,course and location variation in 124 (6.57％)nerves,variation in relationship with inferior thyroid artery (ITA)in 36 (1.91％)nerves,variation at the Berry ligament in 112 (5.94％) nerves,variation at the cricothyroid joint in 17 (0.80％) nerves,and 6 (0.32％)cases of non-recurrent laryngeal nerve (nRLN).Conclusions Variations in RLN found during thyroid surgery are of relatively high incidence,complex and diverse,which can be a potential reason of nerve injury due to visual misidentification.Thus,a thorough knowledge of the normal anatomy of RLN and its anatomic variations ensures a safe and effective thyroid surgery.
