Anatomic variations of the recurrent laryngeal nerve according to the inferior thyroid artery and their clinical impact in patients undergoing thyroidectomy

Abstract

Introduction: Recurrent laryngeal nerve (RLN) identification is the gold-standard technique of thyroidectomy, determining the security of nerve function. This study aims to assess the topographic relationship between RLN and inferior thyroid artery (ITA) in patients undergoing total thyroidectomy, along with its clinical impact. Materials and Methods: A retrospective study was performed including patients undergoing total thyroidectomy in a single tertiary center over a 6-month period. Results: Sixty-four patients were included. Among the 128 RLN dissections, nerve identification traversing ITA anteriorly was found in 27.3%, with equal distribution between the two sides. No significant sex association was reported. One patient presented transient vocal cord palsy and in 21.9% hypocalcemia was observed, yet there was no statistical association to the topographic variation of RLN. Conclusions: Almost one third of patients presented anatomical variation with superior course of the RLN to ITA. RLN variation had no clinical impact on local complications and hypocalcemia. © 2022 Cambridge University Press. All rights reserved.