Topography of the recurrent laryngeal nerve in relation to the thyroid artery, Zuckerkandl tubercle, and Berry ligament in Kenyans

Abstract

Injury to the recurrent laryngeal nerve (RLN) is an important but avoidable complication of thyroidectomy. This complication may be avoided by the identification of the nerve facilitated by important landmarks found along its course. The setting for this work is the Human Anatomy Laboratory of the University of Nairobi. The aim of this work is to determine the topographic relationship of the RLN with the inferior thyroid artery (ITA), the tubercle of Zuckerkandl (TZ), and the ligament of Berry (LB) in a Kenyan population. The relationship between the nerve and the above landmarks was determined during dissection of 146 right and left thyroid lobes. One right side of the neck had a nonrecurrent nerve. Of the specimens where relationship was determined, the nerve was anterior to the ITA in 37% of cases and posterior in 51.4%. In relation to the LB, 45.3% were superficial (dorsolateral). The TZ was clearly delineated in 86 of the 146 specimens. No nerve traversed the tubercle. The RLN exhibited variations similar to those in other populations. The TZ when present was a reliable landmark to the nerve.