A functional assessment of anatomical variants of the recurrent laryngeal nerve during thyroidectomies using neuromonitoring

Purpose The aim of the study was to assess the usefulness of intraoperative neuromonitoring (IONM) in identifying anatomical variants of the recurrent laryngeal nerve (RLN) during thyroidectomies, with emphasis on the nerve’s relationship to the inferior thyroid artery (ITA), Zuckerkandl’s tubercle,...

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Bibliographic Details
Published in:Endocrine 2018-01, Vol.59 (1), p.82-89
Main Authors: Wojtczak, Beata, Kaliszewski, Krzysztof, Sutkowski, Krzysztof, Bolanowski, Marek, Barczyński, Marcin
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Body mass index
Cohort Studies
Diabetes
Endocrine Surgery
Endocrinology
Female
Fruits
Humanities and Social Sciences
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
Monitoring, Intraoperative - methods
multidisciplinary
Nerves
Recurrent Laryngeal Nerve - diagnostic imaging
Recurrent Laryngeal Nerve - pathology
Recurrent Laryngeal Nerve - physiopathology
Science
Statistical analysis
Surgery
Thyroid
Thyroid Diseases - pathology
Thyroid Diseases - surgery
Thyroid gland
Thyroid Gland - pathology
Thyroid Gland - physiopathology
Thyroid Gland - surgery
Thyroidectomy - methods
Young Adult
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Summary:Purpose The aim of the study was to assess the usefulness of intraoperative neuromonitoring (IONM) in identifying anatomical variants of the recurrent laryngeal nerve (RLN) during thyroidectomies, with emphasis on the nerve’s relationship to the inferior thyroid artery (ITA), Zuckerkandl’s tubercle, nonrecurrent laryngeal nerves (NRLNs), and extralaryngeal bifurcation. Methods A total of 128 subjects undergoing surgery for thyroid disorders were enrolled in the study, and the course and anatomical variants of RLN were assessed with IONM application. Results The standard relationship between RLN and ITA was that the artery and nerve intersect (100%). The right RLN was below the ITA in 76.67% of the patients, and the left RNL was below it in 75.81%. There were no statistically significant differences in the relationship between RLN and ITA on the two sides; and gender did not significantly influence the relationship between the RLN and ITA on either side. In one patient a nonrecurrent inferior laryngeal nerve was present on the right side (0.83%). RLN bifurcation was observed in 33.33% of the patients on the right and in 19.35% on the left side; the difference between sides was statistically significant ( p  
ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-017-1466-3