The use of the inferior cornu of the thyroid cartilage in identifying the recurrent laryngeal nerve.

The inferior thyroid artery, traditionally used as a guide in identifying the recurrent laryngeal nerve, is not wholly reliable because of two factors which affect the constancy of the relation between nerve and artery. One is the variability of the anatomic pattern of tbe inferior thyroid artery, and the other is the occasional incidence of a nonrecurrent inferior laryngeal nerve. In a study of 500 recurrent laryngeal nerves, the inferior cornu of the thyroid cartilage was more reliable than the inferior thyroid artery in identifying the recurrent laryngeal nerve. The anatomic relation between the recurrent laryngeal nerve and the inferior cornu of the thyroid cartilage was constant in all patients, except those in whom there was displacement of the nerve resulting from lesions of the thyroid or the parathyroid glands. Operations upon the neck require understanding of the anatomic characteristics of the recurrent laryngeal nerve and of possible involvement of the nerve with the pathologic process involvement of the nerve with the pathologic process as well as fastidious operative technique.