Preoperative diagnosis of right nonrecurrent inferior laryngeal nerve by CT scan: report of a case and review of the literature.
OBJECTIVE
The nonrecurrent inferior laryngeal nerve (NRILN) is a nerve anomaly that is associated with the developmentally aberrant subclavian artery. Thus, it is possible to predict NRILN by preoperative diagnosis of an aberrant subclavian artery. The purpose of this study was to report a new case of this anomaly and to assess the possibility of diagnosis of an aberrant subclavian artery preoperatively by CT scan of the neck, underline how such recognition is crucial for the prevention of intraoperative nerve damage and review the literature.


METHODS
We report a case of thyroid surgery associated with a right NRILN diagnosed preoperatively by CT scan of the neck.


RESULTS
The preoperative CT scan showed a retroesophageal aberrant right subclavian artery. The patient underwent total thyroidectomy for a multinodular goiter. She had identification of recurrent laryngeal nerve on the left side and NRILN on the right side. Postoperatively, the patient had normal vocal cord function on laryngoscopy.


CONCLUSIONS
It was possible to predict preoperatively a right NRILN by identifying an aberrant right subclavian artery on the CT film of the neck, which likely enabled the prevention of vocal cord paralysis.
Abboud
Bassam
B
Department of General Surgery, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. dbabboud@yahoo.fr
D000368:Aged; D005260:Female; D006045:Goiter, Substernal / Q000000981:diagnostic imaging; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012009:Recurrent Laryngeal Nerve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D014057:Tomography, X-Ray Computed