Abstract
Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two patients. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations. Case report: patient aged 28 and 58 admitted for goiter. They underwent a right lobisthmectomy. Both recurrences were approached retrograde. The anatomical variations of the nerve concerned the non-recurrent laryngeal nerve in the first patient. In the second patient there were three anatomical variations, namely an extra laryngeal bifurcation of the nerve, a pre-vascular position of the nerve and a branch connecting the vagus nerve and the recurrent nerve. No recurrence nerve injury was noted. Conclusion: The anatomical variations of the nerve are numerous. A careful dissection is a guarantee of a good prognosis.
Highlights
The thyroid surgery requires anatomy awareness of the front and side of the neck, pharynx, laryngeal structures and any anatomical variation on the recurrent nerve [1]
We report two types of anatomical variations of the recurrent laryngeal nerve in two patients
Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations
Summary
The thyroid surgery requires anatomy awareness of the front and side of the neck, pharynx, laryngeal structures and any anatomical variation on the recurrent nerve [1]. The identification and dissection is complicated and delicate for the subsequent plurality of anatomical variations. These variations are sources of vulnerability of the recurrent nerve [2]. These are the extra laryngeal divisions of the nerve, the link of the nerve to the inferior thyroid artery and the recurrent non-recurrent nerve. These variations can be related to thyroid pathology. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical involvement of these almost rare variations
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