Recurrent Laryngeal Nerve A Plexus Rather Than a Nerve?

Recurrent Laryngeal Nerve A Plexus Rather Than a Nerve?

Author Cernea, Claudio R. Google Scholar
Hojaij, Flavio Carneiro Autor UNIFESP Google Scholar
De Carlucci, Dorival Autor UNIFESP Google Scholar
Gotoda, Renato Google Scholar
Plopper, Caio Google Scholar
Vanderlei, Felipe Autor UNIFESP Google Scholar
Brandao, Lenine Garcia Autor UNIFESP Google Scholar
Institution Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives: To analyze the frequency of extralaryngeal branching (ELB) of the recurrent laryngeal nerve (RLN) in a consecutive series of patients undergoing thyroidectomy by the same group of surgeons during an extended period and to compare our findings with the data available in the literature.Design: Retrospective medical record study.Setting: Academic research.Patients: From March 1, 1983, to September 30, 2008, 2677 patients underwent thyroidectomy. Of these, 1638 patients had surgical information about at least 1 RLN. A total of 1081 patients underwent bilateral operations. During the last 5 years of the study, intraoperative laryngeal nerve monitoring was performed in selected patients using a commercially available system.Main Outcome Measures: Information was obtained regarding 2154 RLNs.Results: A total of 1390 RLNs (64.53%) had ELB. Among 447 patients in whom intraoperative laryngeal nerve monitoring was used, the anterior branches usually exhibited more electrophysiologic activity.Conclusions: Extralaryngeal branching was found in 64.53% of RLNs in this case series. In recent patients with intraoperative laryngeal nerve monitoring, electrophysiologic activity was observed in the branches, particularly the anteriorly situated ones. Recognition of this frequent anatomical configuration and meticulous preservation of all branches are of paramount importance to decrease postoperative morbidity associated with thyroidectomy.
Language English
Date 2009-11-01
Published in Archives Of Otolaryngology-head & Neck Surgery. Chicago: Amer Medical Assoc, v. 135, n. 11, p. 1098-1102, 2009.
ISSN 0886-4470 (Sherpa/Romeo, impact factor)
Publisher Amer Medical Assoc
Extent 1098-1102
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000271860900006

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