J Endocr Surg.  2018 Sep;18(3):205-209. 10.16956/jes.2018.18.3.205.

Nonrecurrent Laryngeal Nerve Identification and Preservation during Transoral Robotic Thyroidectomy

Affiliations
  • 1Department of Surgery, Keimyung University School of Medicine, Daegu, Korea. chojh0404@dsmc.or.kr
  • 2Department of Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

The nonrecurrent laryngeal nerve (NRLN), a rare, anatomic variation of the recurrent laryngeal nerve, is associated with increased injury risk during thyroid surgery. Here, we report a 44-year-old female presenting with right NRLN, receiving transoral robotic thyroidectomy with intraoperative neuromonitoring (IONM). Ultrasonogram of the patient's thyroid gland revealed a solitary nodule, with fine-needle aspiration cytology, indicating papillary carcinoma. Preoperative computed tomography scan revealed an aberrant right subclavian artery arising from the distal aortic arch, suggesting right NRLN. During transoral robotic hemi-thyroidectomy, IONM identified a NRLN emanating from the right vagus nerve and entering the larynx. The post-operative period was uneventful, and laryngoscopic examination demonstrated normal vocal cord movement with no changes observed in patient voice. This is the first report of transoral robotic thyroidectomy in a patient with NRLN. During transoral thyroidectomy, the right NRLN was easily identified and its integrity was preserved utilizing IONM.

Keyword

Thyroidectomy; Recurrent laryngeal nerve; Aberrant subclavian artery

MeSH Terms

Adult
Anatomic Variation
Aorta, Thoracic
Biopsy, Fine-Needle
Carcinoma, Papillary
Female
Humans
Laryngeal Nerves*
Larynx
Recurrent Laryngeal Nerve
Subclavian Artery
Thyroid Gland
Thyroidectomy*
Ultrasonography
Vagus Nerve
Vocal Cords
Voice
Full Text Links
  • JES
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error