Sofia Guerreiro
Setubal Medical Center, Portugal
Title: The non-recurrent laryngeal nerve: An anatomical “trapâ€
Biography
Biography: Sofia Guerreiro
Abstract
The existence of anatomic variants in the path of the inferior laryngeal nerve (ILN) is an additional reason to enhance their preoperative identification. One of these variants is the nonrecurrent inferior laryngeal nerve (NRILN) whose incidence ranges from 0.3% to 1.6% for the right and it is approximately 0.04% for the left. Its presence on the right is a consequence of a right subclavian artery variant that arises directly from the aortic arch behind the esophagus. Therefore, the absence of recurrence of the inferior laryngeal nerve results from an embryological variant. NRILN incidence is very rare, but when present, increases the risk of damage during thyroidectomy. Preoperative imagiologic diagnosis of arteria lusoria and dysphagia lusoria may suggest its presence. We describe a patient without dysphagia but with NRILN which was an incidental discovery through CT scan. We present this case because it highlights this anatomical variant. There are auxiliary methods that allow intra-operatory identification, as intraoperative neuro-monitoring (IONM). The knowledge of NRILN presence and a correct surgical technique minimize morbidity.