Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T19:38:47.951Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-recurrent inferior laryngeal nerve identification during robotic thyroidectomy

Published online by Cambridge University Press:  30 January 2014

C-C Wang  and
C-H Wu
C-C Wang*
Affiliation:
School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Otolaryngology, Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan School of Speech Language Pathology and Audiology, Chung-Shan Medical University, Taichung, Taiwan
C-H Wu
Affiliation:
Department of Radiology, Taichung Veterans General Hospital, Taipei, Taiwan Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
*
Address for correspondence: Dr C-C Wang, Department of Otolaryngology, Head and Neck Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung 40705, Taiwan Fax: +886-4-23596868 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

A non-recurrent inferior laryngeal nerve is a rare anomaly in which the nerve enters the larynx directly off the cervical vagus nerve, without descending to the thoracic level. It is very susceptible to damage during surgery. This report describes the important pre-operative radiological evaluations and surgical landmarks in a case of a non-recurrent inferior laryngeal nerve, identified during the recently developed technique of robotic thyroidectomy.

Case report:

A 38-year-old woman presented with suspected papillary microcarcinoma, as indicated by aspiration cytology. Pre-operative computed tomography showed a right aberrant subclavian artery that indicated a possible right non-recurrent inferior laryngeal nerve. Using robotic thyroidectomy methods, it was possible to carefully dissect along the thyroid capsule. The laryngeal entrance point of the right non-recurrent inferior laryngeal nerve (a constant anatomical landmark) was successfully identified via the three-dimensional, high-magnification views provided by the robotic endoscope.

Conclusion:

With proper knowledge of radiological and surgical anatomy, and the benefits of high-magnification endoscopic views, a non-recurrent inferior laryngeal nerve can be safely preserved during robotic surgery.

Keywords

ThyroidectomyRecurrent Laryngeal NerveAnatomyRoboticsAberrant Subclavian Artery
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 199 - 202
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Henry, JF, Audiffret, J, Denizot, A, Plan, M. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery 1988;104:977–84Google ScholarPubMed
2Watanabe, A, Kawabori, S, Osanai, H, Taniguchi, M, Hosokawa, M. Preoperative computed tomography diagnosis of non-recurrent inferior laryngeal nerve. Laryngoscope 2001;111:1756–9Google Scholar
3Yalcin, B, Ozan, H. Relationship between the Zuckerkandl's tubercle and entrance point of the inferior laryngeal nerve. Clin Anat 2007;20:640–3Google ScholarPubMed
4Kaisha, W, Wobenjo, A, Saidi, H. Topography of the recurrent laryngeal nerve in relation to the thyroid artery, Zuckerkandl tubercle, and Berry ligament in Kenyans. Clin Anat 2011;24:853–7CrossRefGoogle Scholar
5Pelizzo, MR, Toniato, A, Gemo, G. Zuckerkandl's tuberculum: an arrow pointing to the recurrent laryngeal nerve (constant anatomical landmark). J Am Coll Surg 1998;187:333–6Google Scholar
6Kang, SW, Jeong, JJ, Yun, JS, Sung, TY, Lee, SC, Lee, YS et al. Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 2009;23:2399–406Google Scholar
7Tae, K, Ji, YB, Cho, SH, Lee, SH, Kim, DS, Kim, TW. Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years' experience. Head Neck 2012;34:617–25CrossRefGoogle ScholarPubMed
8Toniato, A, Mazzarotto, R, Piotto, A, Bernante, P, Pagetta, C, Pelizzo, MR. Identification of the nonrecurrent laryngeal nerve during thyroid surgery: 20-year experience. World J Surg 2004;28:659–61Google Scholar
9Stedman, GW. A singular distribution of some of the nerves and arteries of the neck and the top of the thorax. Edinb Med Surg J 1823;19:564–5Google Scholar
10Asgharpour, E, Maranillo, E, Sañudo, J, Pascual-Font, A, Rodriguez-Niedenführ, M, Valderrama, FJ et al. . Recurrent laryngeal nerve landmarks revisited. Head Neck 2012;34:1240–6CrossRefGoogle ScholarPubMed