Page C, Monet P, Peltier J, Bonnaire B, Strunski V
Department of ENT and Head & Neck Surgery, University Hospital of Amiens, Amiens, France.
J Laryngol Otol. 2008 Jul;122(7):757-61. doi: 10.1017/S0022215107008389. Epub 2007 May 22.
We aimed to highlight a rare anatomical variation involving the recurrent laryngeal nerve, and to emphasise its implications for thyroid surgery.
Over a period of 13 years, 993 patients underwent thyroid surgery; 1557 recurrent laryngeal nerves (887 on the right side) were exposed.
Three non-recurrent laryngeal nerves were found on the right side, associated with a retro-oesophageal subclavian artery. One case was suspected before surgery.
Several variations in the path and branches of the recurrent laryngeal nerve have been reported in the literature. The frequency of occurrence of a non-recurrent laryngeal nerve is about 1 per cent, for patients undergoing thyroid surgery. Other surgically relevant anatomical variations of the recurrent laryngeal nerve include associations with the inferior thyroid artery and the presence of nerve branches.
The recurrent laryngeal nerve must be carefully dissected and totally exposed during thyroid surgery in order to best preserve its function. Moreover, the thyroid surgeon must be aware of the existence of anatomical variations, which are not as rare as one may think.
我们旨在突出一种涉及喉返神经的罕见解剖变异，并强调其对甲状腺手术的影响。
在13年的时间里，993例患者接受了甲状腺手术；暴露了1557条喉返神经（右侧887条）。
在右侧发现3条非喉返神经，与食管后锁骨下动脉相关。术前怀疑1例。
文献中已报道了喉返神经走行和分支的几种变异。接受甲状腺手术的患者中，非喉返神经的发生率约为1%。喉返神经其他与手术相关的解剖变异包括与甲状腺下动脉的关联以及神经分支的存在。
在甲状腺手术过程中，必须仔细解剖并完全暴露喉返神经，以最佳地保留其功能。此外，甲状腺外科医生必须意识到解剖变异的存在，其并不像人们想象的那么罕见。
