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Efficient, effective, safe procedure to identify nonrecurrent inferior laryngeal nerve during thyroid surgery
Author(s) -
Watanabe Akihito,
Taniguchi Masanobu,
Kimura Yuki,
Ito Suguru,
Hosokawa Masao,
Sasaki Shigeyuki
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23932
Subject(s) - medicine , recurrent laryngeal nerve , inferior thyroid artery , paralysis , vocal cord paralysis , thyroid , subclavian artery , cord , surgery , radiology , superior laryngeal nerve , vagus nerve , superior thyroid artery , larynx , stimulation
Background The nonrecurrent inferior laryngeal nerve (NRILN) is always associated with the aberrant subclavian artery. CT images can detect this vascular anomaly, which predicts an NRILN. The purpose of this study was to report our procedure to identify the NRILN in patients with the aberrant subclavian artery. Methods Four of 730 patients undergoing thyroid operation in our hospital were preoperatively diagnosed with aberrant subclavian artery by CT of the neck. To avoid vocal cord paralysis, we approached the vagal nerve first before dissecting the paratracheal region to discover the separation point of the NRILN from the vagal nerve. Results The NRILN was identified without difficulty in all 4 patients. No patients showed vocal cord paralysis. Conclusion Approaching the vagal nerve first before dissecting the paratracheal region is an efficient, effective, and safe procedure to identify an NRILN in patients who are preoperatively diagnosed as having the aberrant subclavian artery. © 2015 Wiley Periodicals, Inc. Head Neck 38: 573–577, 2016