Nonrecurrent laryngeal nerve: A rare clinical presentation in thyroid surgery- A report of 2 cases

Abstract

Surgical damage to the inferior laryngeal nerve is one of the most feared complications of thyroid surgery. A detailed knowledge of anatomical variations is necessary. Nonrecurrent inferior laryngeal nerve is a rare anomaly on the right side and is exceptional on the left. The typical course of the inferior laryngeal nerve is due to the embryological development of the aortic arch and supra-aortic vessels, and nonrecurrence is associated with a vascular anomaly such as a right retroesophageal subclavian artery. The nervous anomaly on the left side is possible only with the occurrence of cardiac dextroposition (situs inversus) and a left retroesophageal subclavian artery. The situation is more dangerous when a nonrecurrent branch of the inferior laryngeal nerve is associated with a recurrent branch. This anomaly does not appear to be associated with a vascular anomaly in all cases. We came across two cases of NRLN after performing 965 thyroid surgeries.