Skip to main content

Surgical Approaches to the Recurrent Laryngeal Nerve

  • Chapter
  • First Online:
The Recurrent and Superior Laryngeal Nerves

Abstract

During thyroid and parathyroid surgery, avoiding injury to the recurrent laryngeal nerve (RLN) is critical. Several general principles should be adhered to when performing these surgeries in order to protect the nerve. Visual identification and dissection of the RLN is now the standard technique for its preservation during thyroid surgery. Based on the pathology and indication for surgery, the optimal approach to the RLN, lateral, superior or inferior, should be utilized.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gacek RR, Malmgren LT, Lyon MJ. Localization of adductor and abductor motor nerve fibers to the larynx. Ann Otol Rhinol Laryngol. 1977;86(6):771–6.

    Article  CAS  PubMed  Google Scholar 

  2. Chonkich GD, Petti GH, Goral W. Total thyroidectomy in the treatment of thyroid disease. Laryngoscope. 1987;97(8):897–900.

    Article  CAS  PubMed  Google Scholar 

  3. Barczynski M, Konturek A, Cichon S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg. 2009;96(3):240–6.

    Article  CAS  PubMed  Google Scholar 

  4. Jatzko GR, Lisborg PH, Muller MG, et al. Recurrent nerve palsy after thyroid operations—principal nerve identification and a literature review. Surgery. 1994;115(2):139–44.

    CAS  PubMed  Google Scholar 

  5. Reeve T, Thompson NW. Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg. 2000;24(8):971–5.

    Article  CAS  PubMed  Google Scholar 

  6. Procacciante F, Picozzi P, Pacifici M, Picconi S, Ruggeri S, Fantini A, et al. Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy. World J Surg. 2000;24(5):571–3.

    Article  CAS  PubMed  Google Scholar 

  7. Bliss RD, Gauger PG, Delbridge LW. Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg. 2000; 24(8):891–7.

    Article  CAS  PubMed  Google Scholar 

  8. Akin Jr JT, Skandaliakis JE. Technique of total thyroid lobectomy. Am Surg. 1976;42(9):648–52.

    PubMed  Google Scholar 

  9. Attie JN, Khafif RA. Preservation of parathyroid glands during total thyroidectomy. Improved technic utilizing microsurgery. Am J Surg. 1975;130(4): 399–404.

    Article  CAS  PubMed  Google Scholar 

  10. Henry JF, Audiffret J, Denizot A, et al. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988;104(6): 977–84.

    CAS  PubMed  Google Scholar 

  11. Lore Jr JM, Kim DJ, Elias S. Preservation of the laryngeal nerves during total thyroid lobectomy. Ann Otol Rhinol Laryngol. 1977;86(6):777–88.

    Article  PubMed  Google Scholar 

  12. Sedjwick C. Major problems in clinical surgery. Philadelphia, PA: WB Saunders; 1974.

    Google Scholar 

  13. Lore Jr JM. Practical anatomical considerations in thyroid tumor surgery. Arch Otolaryngol. 1983;109(9): 568–74.

    Article  PubMed  Google Scholar 

  14. Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D. Minimally invasive video-assisted thyroidectomy. Am J Surg. 2001;181(6):567–70.

    Article  CAS  PubMed  Google Scholar 

  15. Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS. Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg. 2009;209(2): e1–7.

    Article  PubMed  Google Scholar 

  16. Terris DJ, Singer MC, Seybt MW. Robotic facelift thyroidectomy: II. Clinical feasibility and safety. Laryngoscope. 2011;121:1636–41.

    Article  PubMed  Google Scholar 

  17. Serpell JW, Yeung MJ, Grodski S. The motor fibers of the recurrent laryngeal nerve are located in the anterior extralaryngeal branch. Ann Surg. 2009;249(4): 648–52.

    Article  PubMed  Google Scholar 

  18. Kandil E, Abdelghani S, Friedlander P, Alrasheedi S, Tufano RP, Bellows CF, et al. Motor and sensory branching of the recurrent laryngeal nerve in thyroid surgery. Surgery. 2011;150(6):1222–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gregory W. Randolph M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kandil, E., Singer, M., Deniwar, A., Randolph, G.W. (2016). Surgical Approaches to the Recurrent Laryngeal Nerve. In: Randolph, G. (eds) The Recurrent and Superior Laryngeal Nerves. Springer, Cham. https://doi.org/10.1007/978-3-319-27727-1_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27727-1_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27725-7

  • Online ISBN: 978-3-319-27727-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics