3D Rendering of Porcine Recurrent Laryngeal Neuroanatomy

Abstract

Recurrent laryngeal nerve (RLN) palsy is a common post‐operative complication of many head and neck surgeries. The best treatment to restore partial function to a damaged RLN is reinnervation of the posterior cricoarytenoid (PCA) muscle via anastomosis of the RLN and phrenic nerves. The pig is an excellent model of human laryngeal anatomy and physiology. A thorough knowledge of porcine laryngeal anatomy is necessary before the pig can be used to improve existing surgical strategies, and develop new ones. This study provides state of the art 3D renderings of the porcine larynx and the location of the RLN and its branches. Anatomical variation of primary RLN branching was analyzed in 25 specimens to reveal 3 major branching patterns. Pattern A (44%) consisted of a medial primary branch that bifurcated into two secondary branches. Pattern B (32%) consisted of three primary branches. Pattern C (24%), consisted of two primary branches. Several heat maps depict the relative spatial variability of 32 bilateral specimens of RLN trunks and primary branches. We show a high degree of variability in whole nerve medial/lateral location within the larynx in left RLN specimens as compared to right RLNs. However, the location of RLN primary branches was more highly conserved among left RLNs. We intend this study to be useful to groups using a porcine model to study PCA reinnervation techniques. This research is funded by the BYU College of Life Sciences Start‐Up Mentoring Grant.