title: An applied anatomical study on the recurrent laryngeal nerve and inferior thyroid artery.
abstract: OBJECTIVE
  The aim of this study was to provide some important information about the morphology and topography of the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA), which significantly helps localize and protect the RLN in neck surgery, especially in thyroid surgery.
  
  
  METHODS
  Eighty adult cadavers (160 sides) fixed with formalin were dissected, analyzed and measured.
  
  
  RESULTS
  (1) 87.5% of the RLNs gave off multiple branches like a tree; the incidence of the RLN loop, connecting one branch to another was 3.125%; in 9.375%, one branch of RLN combined with cervical sympathetic chain (CSC) or superior laryngeal nerve (SLN). (2) A double RLN appeared in four sides, a non-recurrent inferior laryngeal nerve appeared in two cases. (3) In two cases, the RLN communicated with both of the SLN and the CSC near thyroid gland. (4) Most of the ITAs was derived from thyrocervical trunk, and divided into two or three branches before entering the thyroid gland. (5) Three ITAs gave off esophageal branch, one ITA gave off tracheal branch, one right ITA originated abnormally. (6) On the left side, the RLN was behind the ITA in 86.25% of the cases, in front of the artery in 7.5%, the nerve was between artery branches in 2.5%, the artery was between nerve branches in 1.25%, and was among the combined in 2.5%. On the right side, the RLN was in front of the artery in 75.0%, behind the artery in 10.0%, among the branches of the artery in 5.0%, 10.0% the branches of both nerves and artery were interlaced that the relationship between the branches of the nerve and the artery was uncertain.
  
  
  CONCLUSIONS
  Because of the variability of the RLN and ITA and the complicated relationship between them, it is necessary to dissect and recognize the RLN to avoid mistaking, ignoring, and misligating of the nerve before ligating the ITA.
authors: National Class Preclinical Medicine Experimental Teaching Demonstration Center, Chongqing Medical University, Chongqing 400016, China.
authors: Wen-Jing
authors: WJ
authors: Tang
authors: Shan-Quan
authors: SQ
authors: Sun
authors: Xing-Lu
authors: XL
authors: Wang
authors: Yu-Xing
authors: YX
authors: Sun
authors: Hai-Xia
authors: HX
authors: Huang
mesh_terms: D000328:Adult; D002102:Cadaver; D006801:Humans; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology* / Q000601:surgery; D013961:Thyroid Gland / Q000098:blood supply* / Q000601:surgery