The nonrecurrent laryngeal nerve: A clinical anatomic mapping with regard to intraoperative neuromonitoring

Surgery
Marko KonschakeRupert Prommegger

Abstract

We investigated the nonrecurrent inferior laryngeal nerve (nrILN), an important variant in the course of the inferior laryngeal nerve (ILN; 0.5-6.0%). Its importance was demonstrated in a clinical case as well as in cadaver specimens, and the pattern was identified with intraoperative neuromonitoring (IONM). The ILN and the presence of an nrILN were investigated in 36 formaldehyde-embalmed specimens. Our anatomic findings showed differences in the anatomic course of the ILN and thus produced possible explanations for different IONM signals that would correlate with differences in the anatomic course of the ILN. Preoperative ultrasonographic evaluation of the brachiocephalic trunk and the recurrent laryngeal nerve were used for the exclusion or identification of an nrILN, respectively. We found 2 nrILNs (ascending, horizontal; 6%) in the anatomic specimens. These 2 specimens each showed an aberrant right subclavian artery (lusorial artery) and were, therefore, associated with the absence of a brachiocephalic trunk. The intraoperative case displayed a descending nrILN. Signals derived from the vagus nerve were positive if derived proximal to and negative if derived distal to the branching of an nrILN. By ultrasonographic identifi...Continue Reading

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Citations

Nov 8, 2016·Advances in Medicine·Emin Gurleyik, Gunay Gurleyik
May 17, 2018·Asia-Pacific Journal of Clinical Oncology·Miao-Yun LongHong-Hao Li
Apr 6, 2019·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Marko KonschakeMarit Zwierzina
Nov 1, 2016·Langenbeck's Archives of Surgery·Brandon Michael HenryKrzysztof A Tomaszewski
May 18, 2017·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Anthony P Polednak
Aug 25, 2020·Case Reports in Surgery·Carlos Alberto Ferreira de FreitasMarcelo Resende Martins
Dec 24, 2020·Medicina·David KachlíkVladimír Musil

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