Arteria lusoria identified on preoperative CT and nonrecurrent inferior laryngeal nerve during thyroidectomy: a retrospective study.
BACKGROUND
To evaluate surgical identification of nonrecurrence of the inferior laryngeal nerve (NRILN) during thyroidectomy in patients with an aberrant subclavian artery (a. lusoria) as seen on CT.


METHODS
The medical files of patients treated by thyroidectomy between January 1998-December 2000 (n = 583) were retrospectively reviewed for preoperative and postoperative mobility of the vocal cords and perioperative identification of NRILN. The available preoperative CT studies (n = 163) were reviewed for presence of a. lusoria.


RESULTS
In five patients, the CT study revealed an a. lusoria (3.16%). In one of five of these patients, an NRILN was surgically detected; the overall detection rate of NRILN was 0.21%. In one of four patients with nonidentification of this nerve during surgery, immediate unilateral and permanent vocal cord paralysis were present after surgery. No permanent vocal cord paralysis occurred in any of the other patients.


CONCLUSIONS
The identification of a. lusoria should alert the radiologist and surgeon that a NRILN is present, allowing an anticipating surgical technique, reducing the risk of neural injury.
Hermans
Robert
R
Department of Radiology, University Hospitals, Herestraat 49, B-3000 Leuven, Belgium. Robert.Hermans@uz.kuleuven.ac.be
Dewandel
Patricia
P
Debruyne
Frans
F
Delaere
Pierre R
PR
D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D013965:Thyroidectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed