| Abstract: |
Nonrecurrent inferior laryngeal nerve is a rare (NRLN), asymptomatic anomaly. Given the consequences of iatrogenic injury, intimate knowledge of all possible anatomic variations and correlated vascular aberrancies is critical to thyroid surgeons. With awareness and meticulous dissection, injury can be avoided. The routine use of intraoperative nerve monitoring with an algorithm for identifying the nonrecurrent inferior laryngeal nerve may be associated with reduced nerve injury rates. A technique of stimulating both the proximal vagus nerve at the upper border of the thyroid cartilage and the distal vagus nerve at the fourth tracheal ring allows for the reliable intraoperative identification of an NRLN. The surgical approach is predicated on the preoperative absence or knowledge of the vascular anomaly associated with an NRLN and the surgical practice of the operating surgeon in terms of distal or proximal identification of the RLN as it relates to its insertion in the larynx. Each of these factors will impact upon the successful management of this rare anatomic variant. © Springer International Publishing Switzerland 2016. All rights reserved. |
