A CADAVERIC STUDY OF ANATOMICAL VARIATIONS OF RECURRENT LARYNGEAL NERVE

Seema Suryawanshi, Maneesh Joleya, Dhananjaya Sharma

Abstract


Background: Thyroidectomy is commonly performed surgery and it is recognised that damage to R.L.N. is a known complication during thyroidectomy surgery.  Appropriate knowledge of variations of R.L.N. may help to decrease such incidences. There is divided openion regarding deliberate exposure of nerve during thyroidectomy.

Exposure of nerve during surgery was recommended as safe procedure by Berlin (1935)(4) and Sibelieu (1921)(10). For treatment of nerve injury local massage, electrical stimulation and anastamosis of R.L.N. has been made by Frazer, Charles Ballance and Lahey, and Hoover. However, no method of treatment has given satisfactory results hence prevention is of paramount importance 

Objective: To study anatomical variations of R.L.N. on both side. 

Material and Method: A total of 40 cadavers were dissected in the mortuary and Department of Anatomy at NSCB Medical College, Jabalpur.

Results: Right R.L.N. was found away from tracheo-oesophageal groove either intermingled with branches of Inferior thyroid artery or Ant to artery. Left R.L.N. found in the trachoesophageal groove and mostly posterior to inferior thyroid artery or its branches. One aberrant course of R.L.N. has been detected on rt. side. one abnormal course of inf Thyroid artery dissected on left side. In two cadaveric dissection inf. Thyroid artery was absent bilaterally. in 17.5% of cases on the rt. side R.L.N. passed through the substance of thyroid gland.

Conclusion: R.L.N. arises from vagus nerve and run downwards. Knowledge of variation of its course and relation with different structure will be very useful to prevent R. L.N. injury during thyroidectomy.

Keywords


RLN, Anatomical variations, Cadaveric study, Laryngeal nerve, Recurrent laryngeal nerve, Thyroidectomy.

References


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