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Surgical Anatomy of the Recurrent Laryngeal Nerves and its Clinical Applications in Chinese Adults

Surgery Today volume 36, pages 312–315 (2006)Cite this article

Abstract

Purpose

When removing the thyroid gland, great care must be taken to avoid damaging the recurrent laryngeal nerves (RLNs). The present study aims to present a clear picture of certain anatomical features of the RLNs in relation to the inferior thyroid artery (ITA), the tracheoesophageal groove (TE), Berry's ligament, and the inferior cornu of the thyroid cartilage in Chinese adults.

Methods

We removed a collective 120 RLNs from 60 Chinese adult cadavers (52 men and 8 women), and examined their anatomic course and relationship on both sides.

Results

The right and left RLNs were found in the tracheoesophageal groove in 78.3% and 91.3% of cases, respectively. Both RLNs were found posterior to and to the right of the ITA in 80% of cases, and one was found on the left side of the ITA in 91.7%. Most of the RLNs were within 3 mm of Berry's ligament, with a laryngeal entry point about 0.8 cm below and just anterior to the inferior horn of the thyroid cartilage.

Conclusions

The inferior cornu of the thyroid cartilage is a reliable landmark in identifying the RLNs. Racial variations between Caucasians and Chinese may explain some anatomic differences.

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References

  1. PL Williams R Warwick M Dyson LH Bannister (1987) Gray's anatomy EditionNumber37th ed. Churchill Livingstone Edinburgh 1258

    Google Scholar 

  2. WB Farrar (1983) ArticleTitleComplications of thyroidectomy Surg Clin North Am 63 1353–61 Occurrence Handle1:STN:280:BiuD2szmsVc%3D Occurrence Handle6359505

    CAS  PubMed  Google Scholar 

  3. MP Kahky RS Weber (1993) ArticleTitleComplication of surgery of the thyroid and parathyroid gland Surg Clin North Am 73 307–21 Occurrence Handle1:STN:280:ByyB3cnhvFQ%3D Occurrence Handle8456359

    CAS  PubMed  Google Scholar 

  4. JF Moley (1999) ArticleTitlePreservation of the recurrent laryngeal nerve in thyroid and parathroid re-operation Surgery 125 673

    Google Scholar 

  5. H Dedo (1970) ArticleTitleThe paralyzed larynx: an electromyographic study in humans and dog Laryngoscope 70 1455

    Google Scholar 

  6. AR Al-Salihi AW Dabbagh (1989) ArticleTitleAnatomy of the recurrent laryngeal nerve in normal Iraqis Acta Anat 135 245–7 Occurrence Handle1:STN:280:BiaA1cbotVU%3D Occurrence Handle2782020

    CAS  PubMed  Google Scholar 

  7. NL Lekacos PJ Tzardis PG Sfikakis SD Patoulis SD Restos (1992) ArticleTitleCourse of the recurrent laryngeal nerve relative to the inferior thyroid artery and the suspensory ligament of Berry Int Surg 77 287–8 Occurrence Handle1:STN:280:ByyC38zgtVw%3D Occurrence Handle1478811

    CAS  PubMed  Google Scholar 

  8. D Berlin (1935) ArticleTitleThe recurrent laryngeal nerve in total ablation of the normal thyroid gland Surg Gynecol Obstet 60 19

    Google Scholar 

  9. S Sasou S Nakamura H Kurihara (1998) ArticleTitleSuspensory ligament of Berry: its relationship to recurrent laryngeal nerve and anatomic examination of 24 autopsies Head Neck 20 695–8 Occurrence Handle10.1002/(SICI)1097-0347(199812)20:8<695::AID-HED6>3.0.CO;2-3 Occurrence Handle1:STN:280:DyaK1M%2FgsV2msg%3D%3D Occurrence Handle9790290

    Article  CAS  PubMed  Google Scholar 

  10. Thompson NW. Differentiated thyroid carcinoma in children. In: Robbins J, editor. Proceedings of a workshop “Treatment of thyroid cancer in childhood.” NIH, Bethesda, MD, September 10–11, 1992. p. 77–91

  11. CA Wang (1975) ArticleTitleThe use of the inferior cornu of the thyroid cartilage in identifying the recurrent nerve Surg Gynecol Obstet 140 91–4 Occurrence Handle1:STN:280:CSmC3crgtF0%3D Occurrence Handle1209479

    CAS  PubMed  Google Scholar 

  12. JM Lore (1983) ArticleTitlePractical anatomical considerations in thyroid surgery Arch Otolaryngeal heal Neck Surg 109 568–72

    Google Scholar 

  13. MR Pelizzo A Toniato G Gemo (1998) ArticleTitleZuckerkandl's tuberculum: an arrow pointing to the recurrent laryngeal nerve (constant anatomical landmark) J Am Coll Surg 187 333–6 Occurrence Handle10.1016/S1072-7515(98)00160-4 Occurrence Handle1:STN:280:DyaK1cvhtV2juw%3D%3D Occurrence Handle9740193

    Article  CAS  PubMed  Google Scholar 

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Author information

Affiliations

  1. Division of Surgery, Chi-Mei Medical Center, Tainan, Taiwan

    Yih-Huei Uen

  2. Department of Surgery, Veterans General Hospital, Taipei, Taiwan

    Tien-Hua Chen, Yi-Ming Shyr, Cheng-Hsi Su, Jui-Yu Chen & Chen-Shen Lee

  3. Department of Anatomy, National Yang-Ming University, Taipei, Taiwan

    Tien-Hua Chen

  4. Department of Biology and Anatomy, National Defense Medical Center, National Defense University, 161 Ming-Chuan E. Rd. Sec. 6, Taipei, 114, Taiwan

    Jia-Fwu Shyu & Jiang-Chuan Liu

Authors
  1. Yih-Huei Uen
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  2. Tien-Hua Chen
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  3. Jia-Fwu Shyu
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  4. Yi-Ming Shyr
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  5. Cheng-Hsi Su
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  6. Jui-Yu Chen
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  7. Chen-Shen Lee
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  8. Jiang-Chuan Liu
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Uen, YH., Chen, TH., Shyu, JF. et al. Surgical Anatomy of the Recurrent Laryngeal Nerves and its Clinical Applications in Chinese Adults. Surg Today 36, 312–315 (2006). https://doi.org/10.1007/s00595-005-3151-z

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  • DOI: https://doi.org/10.1007/s00595-005-3151-z

Key words

  • Recurrent laryngeal nerve
  • Inferior thyroid artery
  • Tracheoesophageal groove
  • Berry's ligament
  • Inferior cornu of thyroid cartilage