Monitoring the Bifurcated Recurrent Laryngeal Nerve
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초록
Anatomical anomalies of the recurrent laryngeal nerve (RLN) can not only mean an operational challenge in thyroid operations for the endocrine surgeon, but also an increased risk of postoperative vocal cord paralysis (VCP). Atypical courses of the RLN are frequent and observed in about a quarter of the thyroid gland operations. Anatomical RLN variations are represented by an atypical RLN pattern as anterior or lateral to the thyroid gland, an anteriorly RLN to a Zuckerkandl tuberculum nodule, a fixed, splayed, or entrapped RLN with capsular association through fascial bands, an invaded RLN, a nerve posterior to ligament of Berry, a thin <1 mm nerve, or antevascular RLN, a non-RLN, a ramificated RLN. Anatomical variations of RLN rarely can be identified preoperatively. The bifurcated RLN represent a significant anatomical variation because prevention of VCP requires preservation of all branches of the RLN. An awareness of the surgical anatomy and the possible dispositions and ramifications of the RLN is very helpful in avoiding its injury during thyroidectomy. The current report derives from a review of the literature and personal experience on identification, confirmation, and monitoring the bifurcated RLN.
Abstract
Anatomical anomalies of the recurrent laryngeal nerve (RLN) can not only mean an operational challenge in thyroid operations for the endocrine surgeon, but also an increased risk of postoperative vocal cord paralysis (VCP). Atypical courses of the RLN are frequent and observed in about a quarter of the thyroid gland operations. Anatomical RLN variations are represented by an atypical RLN pattern as anterior or lateral to the thyroid gland, an anteriorly RLN to a Zuckerkandl tuberculum nodule, a fixed, splayed, or entrapped RLN with capsular association through fascial bands, an invaded RLN, a nerve posterior to ligament of Berry, a thin <1 mm nerve, or antevascular RLN, a non-RLN, a ramificated RLN. Anatomical variations of RLN rarely can be identified preoperatively. The bifurcated RLN represent a significant anatomical variation because prevention of VCP requires preservation of all branches of the RLN. An awareness of the surgical anatomy and the possible dispositions and ramifications of the RLN is very helpful in avoiding its injury during thyroidectomy. The current report derives from a review of the literature and personal experience on identification, confirmation, and monitoring the bifurcated RLN.
참고문헌 (32)
- Polednak AP, "Relationship of the recurrent laryngeal nerve to the inferior thyroid artery: a comparison of findings from two systematic reviews", Clin Anat, 30, pp.318~321 (2017)
- Rajabian A, "Berry's Ligament and the Inferior Thyroid Artery as reliable anatomical landmarks for the Recurrent Laryngeal Nerve (RLN): a fresh-cadaveric study of the cervical spine. The RLN relevant to spine", Spine J, 17, pp.S33~S39 (2017)
- Henry BM, "The reliability of the tracheoesophageal groove and the ligament of berry as landmarks for identifying the recurrent laryngeal nerve: a cadaveric study and meta-analysis", BioMed Res Int, 2017, pp.4357591~ (2017)
- Henry BM, "Variable relationship of the recurrent laryngeal nerve to the inferior thyroid artery: a meta-analysis and surgical implications", Head Neck, 39, pp.177~186 (2017)
- Uludag M, "A closer look at the recurrent laryngeal nerve focusing on branches & diameters: a prospective cohort study", J Invest Surg, 29, pp.383~388 (2016)
- Cetin F, "Morphology and functional anatomy of the recurrent laryngeal nerve with extralaryngeal terminal bifurcation", Anat Res Int, 2016, pp.9503170~ (2016)
- Ling XY, "A systematic review of variations of the recurrent laryngeal nerve", Clin Anat, 29, pp.104~110 (2016)
- Ngo Nyeki AR, "Recurrent laryngeal nerve landmarks during thyroidectomy", Eur Ann Otorhinolaryngol Head Neck Dis, 132, pp.265~269 (2015)
- Dolezel R, "Clinical relevance and surgical anatomy of non-recurrent laryngeal nerve: 7 year experience", Surg Radiol Anat, 37, pp.321~325 (2015)
- Gregg RL, "Avoiding injury to the extralaryngeal nerves", Ann Otol Rhinol Laryngol, 66, pp.656~678 (1957)
- Katz AD, "Extralaryngeal division of the recurrent laryngeal nerve. Report on 400 patients and the 721 nerves measured", Am J Surg, 152, pp.407~410 (1986)
- Katz AD, "Anastamoses and bifurcations of the recurrent laryngeal nerve--report of 1177 nerves visualized", Am Surg, 59, pp.188~191 (1993)
- Page C, "The inferior laryngeal nerve: surgical and anatomic considerations. Report of 251 thyroidectomies", Surg Radiol Anat, 25, pp.188~191 (2003)
- Wang L, "Anatomic study on the recurrent laryngeal nerve in thyroid surgery", Lin Chuang Er Bi Yan Hou Ke Za Zhi, 19, pp.112~113 (2005)
- Beneragama T, "Extralaryngeal bifurcation of the recurrent laryngeal nerve: a common variation", ANZ J Surg, 76, pp.928~931 (2006)
- Yalçin B, "Laryngeal branching pattern of the inferior laryngeal nerve, before entering the larynx", Surg Radiol Anat, 28, pp.339~342 (2006)
- Yalcin B, "Extralaryngeal division of the recurrent laryngeal nerve: a new description for the inferior laryngeal nerve", Surg Radiol Anat, 30, pp.215~220 (2008)
- Sancho JJ, "Risk factors for transient vocal cord palsy after thyroidectomy", Br J Surg, 95, pp.961~967 (2008)
- Casella C, "Does extralaryngeal branching have an impact on the rate of postoperative transient or permanent recurrent laryngeal nerve palsy?", World J Surg, 33, pp.261~265 (2009)
- Cernea CR, "Recurrent laryngeal nerve: a plexus rather than a nerve?", Arch Otolaryngol Head Neck Surg, 135, pp.1098~1102 (2009)
- Barczyński M, "The overwhelming majority but not all motor fibers of the bifid recurrent laryngeal nerve are located in the anterior extralaryngeal branch", World J Surg, 40, pp.629~635 (2016)
- Fontenot TE, "Gender, race, and electrophysiologic characteristics of the branched recurrent laryngeal nerve", Laryngoscope, 124, pp.2433~2437 (2014)
- Gurleyik E, "Location of motor fibers within branches of the recurrent laryngeal nerve with extralaryngeal terminal bifurcation; functional identification by intraoperative neuromonitoring", Surgery, 158, pp.1339~1344 (2015)
- Uludag M, "Motor function of the recurrent laryngeal nerve: sometimes motor fibers are also located in the posterior branch", Surgery, 160, pp.153~160 (2016)
- Serpell JW, "The motor fibers of the recurrent laryngeal nerve are located in the anterior extralaryngeal branch", Ann Surg, 249, pp.648~652 (2009)
- Kandil E, "Motor and sensory branching of the recurrent laryngeal nerve in thyroid surgery", Surgery, 150, pp.1222~1227 (2011)
- Kandil E, "Recurrent laryngeal nerve: significance of the anterior extralaryngeal branch", Surgery, 149, pp.820~824 (2011)
- Barczyński M, "Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy", Br J Surg, 96, pp.240~246 (2009)
- Barczynski M, "The motor fibers of the recurrent laryngeal nerves are located in the anterior extralaryngeal branch", Ann Surg, 251, pp.773~774 (2010)
- Barczynski M, "Value of the intraoperative neuromonitoring in surgery for thyroid cancer in identification and prognosis of function of the recurrent laryngeal nerves", Endokrynol Pol, 57, pp.343~346 (2006)
- Randolph GW, "Recurrent laryngeal nerve identification and assessment during thyroid surgery: laryngeal palpation", World J Surg, 28, pp.755~760 (2004)
- Chiang FY, "Anatomical variations of recurrent laryngeal nerve during thyroid surgery: how to identify and handle the variations with intraoperative neuromonitoring", Kaohsiung J Med Sci, 26, pp.575~583 (2010)