Aberrant position of nonrecurrent inferior laryngeal nerve: Report of 3 cases and a review of the literature.
The presence of a nonrecurrent inferior laryngeal nerve (NRILN) is a significant risk factor for nerve injury during thyroid, parathyroid, and vascular surgeries involving the paratracheal area of the head and neck. The objective of this report is to review the association between an aberrant right subclavian artery (SCA) identified on preoperative imaging and an NRILN identified intraoperatively during thyroid and parathyroid surgery. We reviewed 3 selected cases in which we preoperatively identified an aberrant right SCA and determined the intraoperative position of the inferior laryngeal nerve on the right. It is important to note that 1 of these cases demonstrated that the inferior laryngeal nerve may be found in its normal anatomic position, coursing inferiorly through the tracheoesophageal groove. This anatomic finding is unexpected in a patient with a preoperatively identified aberrant right SCA. We also performed a literature review of more than 250 cases to investigate the association between an intraoperative finding of NRILN and vascular anomalies on imaging. We found 5 reported cases that involved an aberrant right SCA, predictive of NRILN, with the nerve identified in the tracheoesophageal groove.
Otolaryngology/Head and Neck Surgery Service, Department of Surgery, San Antonio Military Medical Center, 3851 Roger Brooke Dr., San Antonio, TX 78234, USA. s10twillson@gmail.com.
Thomas J
TJ
Willson
Jayne
J
Stevens
Nathan
N
Salinas
Joseph A
JA
Brennan
D000328:Adult; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging / Q000601:surgery*; D006111:Graves Disease / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D012009:Recurrent Laryngeal Nerve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed