title: Recognition and Surgical Techniques for Management of Nonrecurrent Laryngeal Nerve during Carotid Endarterectomy.
abstract: The presence of a nonrecurrent laryngeal nerve (NRLN) during carotid endarterectomy (CEA) may significantly limit the exposure of the surgical field during this operation. Although its reported incidence is rare, NRLN typically overlies the carotid bifurcation and failure to recognize this anatomic variation increases the risk of NRLN injury. A retrospective chart review of all patients who underwent CEA for hemodynamically significant extracranial carotid stenosis between January 2005 and December 2014 was performed. All patients with NRLN encountered intraoperatively were identified. Clinical outcomes, surgical techniques, and complications were reviewed and reported. Four left-sided NRLN were identified and 4 were right sided. No cranial nerve deficits or injuries occurred after CEA in patients where NRLN was encountered. Two distinct surgical techniques were used to manage patients with NRLN and they are discussed in detail.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address: jcjimenez@mednet.ucla.edu.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Jimenez
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Sinan
authors.initials: S
authors.lastname: Jabori
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Gelabert
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Wesley S
authors.initials: WS
authors.lastname: Moore
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Quinones-Baldrich
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Jessica
authors.initials: J
authors.lastname: O'Connell
mesh_terms: D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004210:Dissection; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007823:Laryngeal Nerves / Q000002:abnormalities / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000601:surgery