Chrysikos Dimosthenis, Sgantzos Markos, Tsiaoussis John, Noussios George, Troupis Theodore, Protogerou Vassilios, Spartalis Eleftherios, Triantafyllou Tania, Mariolis-Sapsakos Theodoros
University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece.
Department of Anatomy, Medical School, University of Thessaly, Larissa, Greece.
Acta Medica (Hradec Kralove). 2019;62(2):69-71. doi: 10.14712/18059694.2019.105.
The non-recurrent laryngeal nerve (nRLN) is a rare anatomic variation that every head and neck surgeon must be aware of, in order to avoid intraoperative injury which leads to postoperative morbidity. We are reporting a case of a nRLN in a 47 year old female patient with medullary thyroid carcinoma who was surgically treated with total thyroidectomy and lymph node dissection. Both two inferior laryngeal nerves were identified, fully exposed and preserved along their cervical courses. However, we found that the right inferior laryngeal nerve was non-recurrent and directly arised from the cervical vagal trunk, entered the larynx after a short transverse course and parallel to the inferior thyroid artery. The safety of thyroid operations is dependent on high index of suspicion, meticulous identification and dissection of laryngeal nerves either recurrent or non-recurrent. This leads to minimum risk of iatrogenic damage of the nerves. Complete knowledge of the anatomy of these neural structures, including all their anatomic variations is of paramount importance.
非返喉返神经（nRLN）是一种罕见的解剖变异，每位头颈外科医生都必须知晓，以免术中损伤导致术后发病。我们报告一例47岁女性甲状腺髓样癌患者的非返喉返神经病例，该患者接受了甲状腺全切除术和淋巴结清扫术。术中识别出双侧喉返神经，沿其颈部走行充分暴露并予以保留。然而，我们发现右侧喉返神经为非返神经，直接发自颈迷走神经干，经短距离横行后平行于甲状腺下动脉进入喉部。甲状腺手术的安全性取决于高度的怀疑指数、对喉返神经（无论是否为返神经）的细致识别和解剖。这可将神经医源性损伤的风险降至最低。全面了解这些神经结构的解剖，包括其所有解剖变异至关重要。
