Gurleyik Emin, Dogan Sami, Cetin Fuat
Department of Surgery, Duzce University Medical Faculty.
Cureus. 2017 Mar 5;9(3):e1078. doi: 10.7759/cureus.1078.
The recurrent laryngeal nerve (RLN) has many anatomical variations and various relations with adjacent structures. Identification and total exposure of the cervical part of the RLN was performed during operations on the thyroid gland. An extremely rare anatomical variation of the nerve was encountered during the surgical procedure. Coexistence of both right RLN and non-RLN was observed in one patient surgically treated with total thyroidectomy. We first exposed the right RLN with an extralaryngeal terminal bifurcation at its usual position. Thereafter, we also identified an ipsilateral non-RLN joining the anterior branch of the RLN just before laryngeal entry. A Zuckerkandl's tubercle has pointed out the junction of the two nerves. In this period, the incidence of coexistence of non-RLN and RLN was 0.2% in our series. A non-recurrent course is a rare anatomical variation of the inferior laryngeal nerve. The coexistence of both non-RLN and RLN is an extremely rare anatomical finding which should be taken into account during thyroid surgery.
喉返神经（RLN）存在多种解剖变异，且与相邻结构有不同的关系。在甲状腺手术过程中对RLN颈部进行了识别和完全暴露。手术过程中遇到了一种极其罕见的神经解剖变异。在接受全甲状腺切除术的一名患者中观察到右侧RLN和非RLN同时存在。我们首先在其通常位置暴露了具有喉外终末分支的右侧RLN。此后，我们还在喉入口前发现一条同侧非RLN汇入RLN的前支。祖克坎德尔结节指出了两条神经的汇合处。在此期间，我们系列中出现非RLN与RLN并存的发生率为0.2%。非返行路径是喉下神经一种罕见的解剖变异。非RLN和RLN同时存在是一种极其罕见的解剖学发现，在甲状腺手术中应予以考虑。
