Patterns of the Relationship Between Recurrent Laryngeal Nerve and Inferior Thyroid Artery in the Setting of Total Thyroidectomy: A Prospective Single-Surgeon Study


GÜRLÜLER E.

INDIAN JOURNAL OF SURGERY, cilt.87, sa.2, ss.360-364, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 87 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s12262-024-04177-9
  • Dergi Adı: INDIAN JOURNAL OF SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, Veterinary Science Database
  • Sayfa Sayıları: ss.360-364
  • Anahtar Kelimeler: Anatomical landmark, Anterior pattern, Inferior thyroid artery, Injury, Posterior pattern, Recurrent laryngeal nerve, Thyroidectomy
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

This study aimed to determine the anatomical position of recurrent laryngeal nerve (RLN) relative to inferior thyroid artery (ITA) in a consecutive total thyroidectomy series. A total of 421 patients (mean (min-max) age: 45.6 (18-78) years, 76.2% were women) who had total thyroidectomy accompanied with intraoperative exposure of the bilateral RLNs were included in this prospective single-surgeon thyroidectomy series study. Patient demographics and thyroidectomy indications (benign and malignant) were recorded in each patient. The relation of RLN to ITA was assessed bilaterally using the 3-subtype system (anterior to the ITA, posterior to the ITA, and between the branches of the ITA). Most of the thyroidectomy indications (69.1%) were related to malignant disease including papillary carcinoma in 54.9% of cases. The posterior RLN-ITA pattern was the most commonly noted pattern, regardless of the side (74.1% on the left and 68.4% on the right), followed by the anterior RLN-ITA pattern (17.3% on the left and 21.1% on the right) and the between pattern (8.6% on the left and 10.4% on the right). In conclusion, this prospective single-surgeon thyroidectomy series study regarding the position of RLN relative to ITA indicate the predominance of posterior RLN-ITA pattern, similarly, on both the right and the left sides. Accordingly, our findings do not support the higher prevalence of "anterior" or "between" RLN-ITA patterns on the right side, opposing the consideration of right RLN to be at a higher risk of iatrogenic injury.