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Anatomical variation in the right non-recurrent laryngeal nerve reported from studies using pre-operative arterial imaging

Surgical and Radiologic Anatomy May 18, 2019

Polednak AP - Researchers analyzed 8 English language surgical studies reporting on anatomical variation in the right non-recurrent (inferior) laryngeal nerve (NRLN) using pre-operative imaging (POI). The studies reported at least 1 NRLN and had anatomical information. They identified 88 right NRLNs, 69.3% were classified as type 2 (NRLNs arising near the upper pole of the thyroid gland) and 30.7% as type 1 (NRLNs arising at a lower level). Twenty-two (59.5%) of 37 type 2 nerves were type 2a (ie, running at or above the inferior thyroid artery) in a subgroup of 5 POI studies with information on subtypes. Similarly, 60.4% of all 91 type 2 NRLNs were noted to be of type 2a in a separate review of large surgical series without POI. Findings may have implications considering the increasing numbers of anterior neck surgeries including bilateral thyroidectomies.
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