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External laryngeal nerve landmarks revisited
Author(s) -
Ortega Consuelo,
Maranillo Eva,
McHanwell Steve,
Sañudo Jose,
VázquezOsorio Teresa
Publication year - 2018
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.25186
Subject(s) - medicine , anatomy , superior thyroid artery , cadaver , superior laryngeal nerve , pharynx , recurrent laryngeal nerve , inferior thyroid artery , external carotid artery , thyroid , surgery , carotid arteries , larynx
Background Because external laryngeal nerve (ELN) iatrogenic damage is frequent during neck surgery, its precise localization has been highly recommended. This study analyzes the different surgical landmarks previously proposed and the anatomy of the collateral and terminal branches of the ELN. Methods The necks of 157 (77 men and 80 women) human adult embalmed cadavers were examined. The ELN origin, length, and relationship to different landmarks were recorded and results statistically compared with those previously reported. Results The ELN is located deep to the ascending pharyngeal vein in 100% of patients. In most patients, it crosses the carotid axis at the thyroid artery origin level (47% of patients), passes medial to it (89% of patients), and shows an intramuscular trajectory through the inferior constrictor of the pharynx (80% of patients). Conclusion The ELN position, in relation to classical landmarks, is highly variable. The most reliable relationships are those with the ascending pharyngeal vein or with the superior thyroid artery.