Volume 45, Issue 6 pp. 853-856
ORIGINAL ARTICLE

Prospective anatomical study to determine the site of insertion of recurrent laryngeal nerve into the larynx

James X. Wu

Corresponding Author

James X. Wu

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Correspondence

James X. Wu, UCLA David Geffen School of Medicine, 10833 Le Conte Ave, CHS 72-228, Los Angeles, CA 90095.

Email: [email protected]

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Martin Hanson

Martin Hanson

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Shivangi Lohia

Shivangi Lohia

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Hao Li

Hao Li

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Laura Wang

Laura Wang

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ashok R. Shaha

Ashok R. Shaha

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ian Ganly

Ian Ganly

Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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First published: 23 June 2020

Abstract

Objectives

Determine whether the insertion site of the recurrent laryngeal nerve (RLN) occurs at a predictable distance from the midline trachea, to help guide safe dissection during thyroid surgery.

Design

Prospective clinical trial. At the inferior edge of the cricoid cartilage, we measured the distance from mildline trachea to the RLN insertion site.

Setting

Single institution.

Participants

50 consecutive patients undergoing thyroid surgery.

Main outcome measures

Distance from midline trachea to laryngeal insertion of RLN.

Results

The study population included 36 women and 14 men, with 72 total nerves measured. The average distance-to-midline + standard deviation (range) of the RLN was 20.7 + 2.3 (17-26) mm in women compared to 26.3 + 2.1 (22-32) mm in men.

Conclusion

The insertion point of the RLN into the larynx at the level of inferior border of the cricoid cartilage can be reliably predicted, to facilitate early identification of the RLN during thyroid surgery.

CONFLICT OF INTEREST

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

DATA AVAILABILITY STATEMENT

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.