[Anterior approach to the cervical vertebrae and the location of the recurrent laryngeal nerve].
It is well known that the recurrent laryngeal nerve is often damaged during or following an anterior approach to the cervical vertebral column. Reports in the literature suggest that the right-sided approach gives rise to more complications of the recurrent nerve than the left-sided approach and that the right recurrent nerve is in a less protected position. There are also studies addressing the risks involved in the right-sided and the left-sided approach and suggesting the opposite conclusion. In our study, the position of the recurrent nerve was found to be variable and even to be different on the right and left sides in the same person. In 44.6% of cases (45 of 101) the recurrent nerve was found to be have an intermediate course (at the dorsal edge of the trachea or in the sulcus between trachea and esophagus) on both sides. The recurrent nerve was in an anterior position (lateral of the ventral two-thirds or the dorsal one-third of the trachea) in 50.5% (51 cases) on the left and in 49.5% (50 cases) on the right. A posterior position (lateral to the esophagus) of the recurrent nerve was found in 4.9% (5 cases) on the left and in 5.9% (6 cases) on the right. All combinations are possible. The position of the recurrent nerve cannot be inferred from its position on the opposite side. The right-sided or the left-sided approach cannot be preferred on the basis of the position of the recurrent nerve.(ABSTRACT TRUNCATED AT 250 WORDS)
Menck
J
J
Abteilung für Neuroanatomie, Anatomisches Institut der Universität Hamburg.
Grüber
J
J
Lierse
W
W
D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007823:Laryngeal Nerves / Q000033:anatomy & histology*; D008297:Male; D010243:Paralysis / Q000209:etiology; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology*; D061226:Recurrent Laryngeal Nerve Injuries
Vorderer Zugang zur HWS und die Lage des N. laryngeus recurrens.