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BMJ Case Rep ; 20172017 Mar 17.
Article in English | MEDLINE | ID: mdl-28314807

ABSTRACT

Non-recurrence and extralaryngeal branching are 2 of the more frequently encountered anomalies of the recurrent laryngeal nerve. If not anticipated intraoperatively, these abnormalities can put the nerve at risk, with subsequent vocal cord palsy. It is therefore important to report on and understand these abnormalities. We present a unique case of a non-recurrent laryngeal nerve with a coexisting contralateral nerve demonstrating extralaryngeal branching. This case allows us to demonstrate the importance of arteria lusoria in head and neck surgery, and to conclude that non-recurrence and extralaryngeal branching can occur separately within individual nerves in the same patient. The case also highlights the importance of a systematic intraoperative approach to the identification of every recurrent laryngeal nerve, especially in bilateral procedures having already exposed an anomalous nerve on one side.


Subject(s)
Intraoperative Complications/prevention & control , Recurrent Laryngeal Nerve/anatomy & histology , Recurrent Laryngeal Nerve/diagnostic imaging , Aged , Carcinoma/diagnosis , Carcinoma/pathology , Carcinoma/secondary , Carcinoma/surgery , Carcinoma, Papillary , Female , Humans , Lymph Nodes/pathology , Lymph Nodes/surgery , Recurrent Laryngeal Nerve/abnormalities , Subclavian Artery/abnormalities , Subclavian Artery/anatomy & histology , Subclavian Artery/diagnostic imaging , Thyroid Cancer, Papillary , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Thyroid Neoplasms/secondary , Thyroid Neoplasms/surgery , Thyroidectomy/methods
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