Abstract

Introduction: Thyroidectomy is a common surgical procedure performed for a variety of thyroid disorders. NLR injury is a dreaded complication during thyroidectomy and is considered a challenge even by the most experienced surgeons. Case Report: A thirty-two-year-old female patient with no significant pathological history was admitted for management GMNH. Cervical ultrasonography revealed a multiheteronodular goitre classified as TIRADS 4, the largest nodule measuring four centimetres on the left, with no cervical adenopathy. Thyroid workup was normal. Thyroid cytology of nodule number 1 was consistent with follicular neoplasm (Bethesda stage four). A total thyroidectomy was performed, and a bilateral trifurcation of the two recurrent laryngeal nerves in the tracheoesophageal groove was found. Conclusion: Damage to the NLR is the most serious complication of thyroid surgery. Anatomical variations in the NLR increase the risk of iatrogenic nerve damage. Bilateral trifurcation of the recurrent laryngeal nerve is a relatively rare anatomical variation that should not be overlooked when locating this nerve for surgery.

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