A Loop-Forming Duplicate Recurrent Laryngeal Nerve: Report of a Case and Clinical Relevance in Thyroid Surgery

Sato, Tomoyuki; Ogura, Shigeto; Kanazawa, Kyotaro; Nagai, Hideo; Okazaki, Mutsumi
October 2001
American Surgeon;Oct2001, Vol. 67 Issue 10, p992
Academic Journal
This is a report of a unilateral loop-forming duplicate recurrent laryngeal nerve and its clinical relevance. A 72-year-old woman with a giant goiter underwent a total thyroidectomy. At operation we identified two recurrent laryngeal nerves on the right side and one on the left side. The nerve on the right was smaller and displaced laterally by the goiter, whereas the other was adjacent to the trachea and behind the goiter, and it was accidentally divided. Both nerves were united before innervating the larynx. The divided nerve was microsurgically reanastomosed but a postoperative assessment revealed hoarseness. This case report of an anomalous loop-forming duplicate recurrent laryngeal nerve indicates that it may not be sufficient to identify a single recurrent laryngeal nerve on one side during thyroid surgery especially when the observed recurrent nerve is relatively smaller than usual.


Related Articles

  • COMPARISON OF VARIOUS METHODS OF ELECTROMYOGRAPHIC MONITORING OF THE RECURRENT LARYNGEAL NERVE IN THYROID SURGERY. Tschopp, Kurt P.; Gottardo, Christine // Annals of Otology, Rhinology & Laryngology;Sep2002, Vol. 111 Issue 9, p811 

    In the present study, 3 types of electrodes for recurrent laryngeal nerve (RLN) monitoring are compared: 1) intralaryngeal surface electrodes attached to a conventional endotracheal tube, 2) monopolar needle electrodes placed on the vocal cords by direct laryngoscopy, and 3) bipolar needle...

  • Identification of the Nonrecurrent Laryngeal Nerve during Thyroid Surgery: 20-Year Experience. Toniato, Antonio; Mazzarotto, Renzo; Piotto, Andrea; Bernante, Paolo; Pagetta, Costantino; Pelizzo, Maria Rosa // World Journal of Surgery;Jul2004, Vol. 28 Issue 7, p659 

    The nonrecurrent laryngeal nerve, which is rarely observed during thyroidectomy, is at high risk for damage. During a 20-year period 6000 thyroidectomies were performed at our institution, and during these operations inferior laryngeal nerves were routinely identified in all the patients with a...

  • Electrophysiologic laryngeal nerve monitoring in high-risk thyroid surgery. Song, Phillip; Shemen, Larry // ENT: Ear, Nose & Throat Journal;Jun2005, Vol. 84 Issue 6, p378 

    We recently began performing intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve during high-risk thyroidectomies. Neuromonitoring can detect stimulation of these nerves and thereby prevent a mechanical or thermal...

  • Damaged laryngeal nerves in thyroid surgery.  // British Medical Journal;8/13/1977, Vol. 2 Issue 6084, p416 

    Focuses on the damage of laryngeal nerve as an inevitable complication of thyroid surgery. Importance of laryngoscopy both before and after operation; Avoidance of the hazard of the damage to the nerve; Anatomy of the recurrent laryngeal nerve.

  • The weepy nerve-different sensitivity of left and right recurrent laryngeal nerves under tensile stress in a porcine model. Lamadé, Wolfram; Béchu, Maren; Lauzana, Ester; Köhler, Peter; Klein, Sabine; Tuncer, Tuncay; Rashid, Noor; Kahle, Erich; Erdmann, Bertram; Meyding-Lamadé, Uta // Langenbeck's Archives of Surgery;Nov2016, Vol. 401 Issue 7, p983 

    Purpose: Recurrent laryngeal nerve palsy in thyroid surgery is still a threatening complication. Our aim was to analyze the impact of prolonged tensile stress on the recurrent laryngeal nerve (RLN) in an animal model using continuous intraoperative neuromonitoring (C-IONM). Methods: Constant...

  • The efficacy and safety of total thyroidectomy in the management of benign thyroid disease: a review of 932 cases. Efremidou, Eleni I.; Papageorgiou, Mcihael S.; Liratzopoulos, Nikolaos; Manolas, Konstantinos J. // Canadian Journal of Surgery;Feb2009, Vol. 52 Issue 1, p39 

    Background: Total thyroidectomy is currently the preferred treatment for thyroid cancer, multinodular goitre and Graves disease; however, many surgeons choose not to perform total thyroidectomy to treat benign thyroid diseases owing to the associated risk of postoperative hypoparathyroidism and...

  • Does Extralaryngeal Branching Have An Impact on the Rate of Postoperative Transient or Permanent Recurrent Laryngeal Nerve Palsy? Casella, Claudio; Pata, Giacomo; Nascimbeni, Riccardo; Mittempergher, Francesco; Salerni, Bruno // World Journal of Surgery;Feb2009, Vol. 33 Issue 2, p261 

    This prospective study assessed the prevalence of the extralaryngeal branching of the recurrent laryngeal nerve (RLN) and its impact on the incidence of postoperative transient or permanent RLN palsy. Total or hemithyroidectomy was performed in 115 patients, with a total of 195 RLNs displayed....

  • Nonrekürren ve rekürren laringeal sinir birleÅŸimi: Olgu sunumu. Yetişir, Fahri; Dündar, Halit Ziya; Bozkurt, Birkan; Özkardeş, Alper Bilal; Aydın, Seyid Murat; Kııç, Mehmet // Journal of Dialog in Endocrinology / Endokrinolide Diyalog Dergi;Jun2012, Vol. 9 Issue 2, p88 

    The injury of recurrent laryngeal nerve is a serious complication in thyroid surgery. The anatomy of the recurrent laryngeal nerve is variable. A nonrecurrent right laryngeal nerve is found in 0.5 to % of individuals. In addition, about 0.2% of patients have both a recurrent and a nonrecurrent...

  • ZmÄ›ny ve VKG obrazu a objektivní hlasové analýze pÅ™i aplikaci minimálnÄ› invazivních technologií a NM v chirurgii Å¡títné žlázy. Zábrodský, M.; Chovanec, M.; Fík, Z.; Bouček, J.; Betka, J. // Otorhinolaryngology & Phoniatrics / Otorinolaryngologie a Foniat;Aug2012, Vol. 61 Issue 3, p148 

    Present trends in the thyroid gland and parathyroid gland surgery head towards minimization of morbidity and mortality, and the effort is therefore oriented to higher safety of surgical interventions. Thanks to technological progress the minimally invasive video-assisted intraoperative approach...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics