Anatomic configurations of the recurrent laryngeal nerve and inferior thyroid artery

BackgroundAlthough much attention has been given to the protection of the recurrent laryngeal nerve in thyroid surgery, cases of nerve injury are still reported occasionally in the literature. In the current study I aimed to describe variable relationships between the recurrent laryngeal nerve and inferior thyroid artery, and also document my findings in the form of high-resolution photographs.MethodsFifty specimens (100 sides) were examined for this project, including 36 male and 14 female cadavers between the ages of 38 and 87 years at death.ResultsA total of 100 sides were investigated, and 100 recurrent laryngeal nerves and 96 inferior thyroid arteries were encountered. I observed a highly variable relationship between the nerve and the artery. According to the location of the main trunk of the nerve and its branches entering to the larynx, I observed 20 types configurations. On the right, the nerve was frequently in front of the artery, and on the left the nerve was often behind the 2 branches of the artery.ConclusionThe relationship of the recurrent laryngeal nerve to the inferior thyroid artery is highly variable. Achieving a safe and effective operation on the thyroid gland is the goal of all surgeons. I imagine that to avoid any injury to the nerve in thyroid surgery demands a thorough knowledge of all types of relationships between them.