Chen Yin-Yang, Liao Chi-You, Yao Chung-Chin
Institute of Medicine, Chung Shan Medical University, Taichung City 40201, Taiwan.
Department of Surgery, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan.
Diagnostics (Basel). 2022 Mar 17;12(3):730. doi: 10.3390/diagnostics12030730.
The recurrent laryngeal nerve (RLN), a branch of the vagus nerve, supplies the motor and sensation function of the larynx. Generally, RLN detours around the right subclavian artery on the right side and the aortic arch on the left side. In a rare anatomical variant, called nonrecurrent laryngeal nerve (NRLN), the nerve takes an aberrant path rather than descending into the thorax as usual. First reported in 1823, NRLN is a rare anomaly arising almost exclusively on the right side, reported in 0.3-0.8% of people, and associated with vascular anomalies of embryonic aortic arch development. The atypical vascular pattern of aberrant subclavian artery (arteria lusoria) running behind the trachea and esophagus allows the vagus nerve to pass freely, which then directly branches out as NRLN at the level of the larynx. On the other hand, cases of left NRLN, only reported in 0.004% of people, are all accompanied by significant pathologies such as situs inversus totalis with opposite vascular pattern of left aberrant subclavian artery. This rare anatomical variation is clinically important, as NLRN is a major risk factor for iatrogenic injury during thyroidectomy, parathyroidectomy, and other invasive procedures in the head and neck region.
喉返神经（RLN）是迷走神经的一个分支，负责喉的运动和感觉功能。一般来说，右侧喉返神经绕过右锁骨下动脉，左侧绕过主动脉弓。在一种罕见的解剖变异中，称为非喉返神经（NRLN），该神经走行异常，而不是像往常一样下行至胸腔。非喉返神经于1823年首次报道，是一种罕见的异常情况，几乎仅出现在右侧，在0.3%-0.8%的人群中被报道，并且与胚胎主动脉弓发育的血管异常有关。异常锁骨下动脉（迷走动脉）走行于气管和食管后方的非典型血管模式，使得迷走神经能够自由通过，然后在喉部水平直接分支成为非喉返神经。另一方面，左侧非喉返神经的病例仅在0.004%的人群中被报道，且均伴有严重的病理情况，如全内脏转位伴左侧异常锁骨下动脉相反的血管模式。这种罕见的解剖变异在临床上具有重要意义，因为非喉返神经是甲状腺切除术、甲状旁腺切除术以及头颈部其他侵入性手术中发生医源性损伤的主要危险因素。
