AB128. SOH24AB_056. The non-recurrent laryngeal nerve in an Irish thyroid surgery population: an 11-year experience
Head & Neck Session

AB128. SOH24AB_056. The non-recurrent laryngeal nerve in an Irish thyroid surgery population: an 11-year experience

Andrew Keane1, Nadia van den Berg2, Patrick Sheahan2

1Department of Otorhinolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland; 2Department of Otorhinolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland

Background: The non-recurrent laryngeal nerve (NRLN) is a rare anatomical variant of the recurrent laryngeal nerve (RLN). It occurs where abnormalities of the aortic arch are present, such as aberrant right subclavian artery, and may be associated with higher risk of iatrogenic injury during thyroid surgery. The presence of NRLN can be detected pre-operatively by ultrasound or volumetric imaging and intra-operatively by direct observation or intra-operative nerve monitoring. To our knowledge, no data has been published on this anomaly in an Irish population. The objective of this study was to ascertain the prevalence of NRLN in a cohort of patients undergoing thyroid surgery in a major head and neck centre in Ireland over an eleven-year period.

Methods: This is a retrospective review of 301 patients in a single-centre undergoing thyroid and parathyroid surgery who underwent pre-operative volumetric imaging of the neck between 2008 and 2019. Patients were identified from a prospectively kept operative database of a single surgeon. Patient imaging and reports were reviewed to identify NRLN, calculate its prevalence and calculate the relative risk of nerve injury in patients with this anomaly.

Results: A total of 1,127 patients were identified from the database, of whom 301 met the inclusion criteria. Three cases of NRLN were identified (n=3) giving a prevalence of 0.99% in this population. No statistically significant difference in nerve injury rates was found for patients with NRLN versus RLN.

Conclusions: The prevalence of NRLN in this population is consistent with international studies and meta-analysis. Although rare, the NRLN represents a clinically important variant of the RLN and one which surgeons operating in the neck should be mindful of. Further data are needed to assess whether NRLN increases relative risk of vocal cord injury.

Keywords: Thyroid; anatomy; recurrent laryngeal nerve (RLN); otolaryngology; head and neck surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab128
Cite this abstract as: Keane A, van den Berg N, Sheahan P. AB128. SOH24AB_056. The non-recurrent laryngeal nerve in an Irish thyroid surgery population: an 11-year experience. Mesentery Peritoneum 2024;8:AB128.

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