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Microanatomical and clinical significance of the recurrent laryngeal nerve in the thyroid region
WANG Qin HU Guo-qin1 XU Sheng-chun*
Acta Anatomica Sinica ›› 2014, Vol. 45 ›› Issue (1) : 80-83.
Microanatomical and clinical significance of the recurrent laryngeal nerve in the thyroid region
Objective To investigate the anatomic characteristics of the recurrent laryngeal nerve in the thyroid region. Methods The recurrent laryngeal nerve and its surrounding structures of 48 adult cadavers were examined with gross anatomical technique. Results The relationship between the recurrent laryngeal nerve and the lateral cricopharyngeal triangle in 48 adult cadavers (96 sides) was detected. The main trunk of the recurrent laryngeal nerve coursed superiorly and entered into the lateral cricopharyngeal triangle either through (29%，28/96 sides) or deep to (71%，68/96 sides) the cricopharyngeal muscle. The entering point of recurrent larynageal nerve into the larynx was（5.9±1.8）mm inferior to the inferior cornu of the thyroid cartilage. At the level of（15.2±5.5）mm inferior to the inferior cornu of the thyroid cartilage，69% (66/96 sides) of the recurrent laryngeal nerve gave off a small branch to the larynx and its entering point into the larynx was (4.8±2.1) mm inferior to the inferior cornu of the thyroid cartilage. The spatial relationship between the recurrent larynageal nerve inferior to connective tissue membrane and the inferior thyroid artery branch was below the triangle， and the nerve ran either in front of (66%，63/96 sides) or posterior to (33%，32/96 sides) the inferior thyroid artery. Conclusion Correct identification and safe dissection of the recurrent laryngeal nerve are essential in surgery. Most of the recurrent larynageal nerve have external laryngeal branch. It is necessary to confirm the entering point of recurrent larynageal nerve into the larynx while trying to find recurrent larynageal nerve based on the location of the inferior cornu of the thyroid cartilage. The relationship between the inferior thyroid artery and the RLN is complicated, thus the inferior thyroid artery may not be considered as the first choice to localize the recurrent laryngeal nerve.
Inferior thyroid artery / Recurrent laryngeal nerve / Microanatomy / Adult
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