title: [Two cases of nonrecurrent inferior laryngeal nerve--different branching levels from vagus nerve].
abstract: We observed two cases of nonrecurrent inferior laryngeal nerve (NRILN). Case 1, a 71 year old man was diagnosed as having papillary carcinoma. NRILN was found during his operation. It directly branched from the right cervical trunk of the vagus nerve at the level of the cricoid cartilage and then entered the larynx after running behind the thyroid gland. Case 2, a 64 year old woman was diagnosed as having primary hyperparathyroidism. In this patient, the NRILN branched at the level of the inferior pole of the thyroid gland, rose up beside the tracheal wall and entered the larynx. In both patients, preoperative CT scan and postoperative MR angiography revealed the aberrant right subclavian artery. A postoperative barium swallow test showed the compression of the esophagus by this anomalous artery in case 1. Although it is possible to predict the presence of NRILN by preoperative imaging tests, the branching level from the vagus nerve is unpredictable. Surgery must be performed with this point in mind, if the presence of NRILN is suspected.
authors.affiliation: Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Japan, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Tetsumi
authors.initials: T
authors.lastname: Konishi
authors.forename: Asami
authors.initials: A
authors.lastname: Fukushima
authors.forename: Shu
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Koji
authors.initials: K
authors.lastname: Kadowaki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okazaki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tsurudome
authors.forename: Naoki
authors.initials: N
authors.lastname: Nagata
authors.forename: Hideaki
authors.initials: H
authors.lastname: Itoh
mesh_terms: D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D006801:Humans; D007823:Laryngeal Nerves / Q000002:abnormalities* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D013348:Subclavian Artery / Q000002:abnormalities* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D014630:Vagus Nerve / Q000473:pathology*