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The Nonrecurrent Inferior Laryngeal Nerve

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The Recurrent and Superior Laryngeal Nerves

Abstract

Nonrecurrent inferior laryngeal nerve is a rare (NRLN), asymptomatic anomaly. Given the consequences of iatrogenic injury, intimate knowledge of all possible anatomic variations and correlated vascular aberrancies is critical to thyroid surgeons. With awareness and meticulous dissection, injury can be avoided.

The routine use of intraoperative nerve monitoring with an algorithm for identifying the nonrecurrent inferior laryngeal nerve may be associated with reduced nerve injury rates. A technique of stimulating both the proximal vagus nerve at the upper border of the thyroid cartilage and the distal vagus nerve at the fourth tracheal ring allows for the reliable intraoperative identification of an NRLN.

The surgical approach is predicated on the preoperative absence or knowledge of the vascular anomaly associated with an NRLN and the surgical practice of the operating surgeon in terms of distal or proximal identification of the RLN as it relates to its insertion in the larynx. Each of these factors will impact upon the successful management of this rare anatomic variant.

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Author information

Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA

    Carrie C. Lubitz M.D., M.P.H.

  2. New York Head and Neck Institute, North Shore Health System, 130 E 77th St, 10th floor, New York, NY, 10075, USA

    Dennis H. Kraus M.D.

  3. The Claire and John Bertucci Endowed Chair in Thyroid Surgery Oncology, Harvard Medical School, Boston, MA, USA

    Gregory W. Randolph M.D.

  4. Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology—Head and Neck surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Gregory W. Randolph M.D.

  5. Department of Surgery, Endocrine Surgery Service, Massachusetts General Hospital, Boston, MA, USA

    Gregory W. Randolph M.D.

  6. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Richard J. Wong M.D.

Authors
  1. Carrie C. Lubitz M.D., M.P.H.
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  2. Dennis H. Kraus M.D.
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  3. Gregory W. Randolph M.D.
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  4. Richard J. Wong M.D.
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Corresponding author

Correspondence to Carrie C. Lubitz M.D., M.P.H. .

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Editors and Affiliations

  1. The Claire and John Bertucci Endowed Cha, Harvard Medical School, Boston, Massachusetts, USA

    Gregory W. Randolph

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Lubitz, C.C., Kraus, D.H., Randolph, G.W., Wong, R.J. (2016). The Nonrecurrent Inferior Laryngeal Nerve. In: Randolph, G. (eds) The Recurrent and Superior Laryngeal Nerves. Springer, Cham. https://doi.org/10.1007/978-3-319-27727-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-27727-1_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27725-7

  • Online ISBN: 978-3-319-27727-1

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