Non-Recurrent Laryngeal Nerve.
The aim of the study was to assess the frequency of non-recurrent laryngeal nerves (Non-RLN).


METHODS
A total of 6110 patients were operated in our hospital between 1 January 2005 and 31 December 2013 for various goiters (5429) and various types of hyperparathyroidism (618). Laryngeal nerve was exposed during operation in 1700 patients from superior aperture of the chest to superior aperture of the larynx. Identification process of RLN was started with dissecting inferior thyroid artery (ITA) and its junction with the nerve. Then main trunk of the nerve was exposed backwards till the region of superior aperture of the chest together with the end portion till the nerve outlet to the larynx.


RESULTS
In the group of 1700 patients, RLN was exposed bilaterally in 1400 (82.4%) and unilaterally in 300 (17.6%). In the group of 3100 dissected RLNs the course of RLN was observed on the right side in 1710 patients and on the left in 1390. Irreversible nature RLN was shown in four cases (0.1%) - four women (02%) aged 42-55 (mean 49.3) - three operated for non-toxic nodular goiter and one for primary hyperparathyroidism. Each time the Non-RLN was seen on the right side. The other patients manifested recurrent character RLN. Moreover, interstitial course of RLN was found on the left side in one man.


CONCLUSIONS
Non recurrent laryngeal nerve is a rare anatomical variation, occurring more frequently on the right side. Surgeon during surgery of the thyroid and parathyroid glands should be aware of its existence to avoid damage.
Grzegorz
G
Buła
Ryszard
R
Mucha
Michał
M
Paliga
Henryk
H
Koziołek
Zbigniew
Z
Niedzielski
Jacek
J
Gawrychowski
D000328:Adult; D000368:Aged; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D007823:Laryngeal Nerves / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D061226:Recurrent Laryngeal Nerve Injuries / Q000517:prevention & control*; D013965:Thyroidectomy / Q000379:methods*