A Novel Surgical Landmark to Identify the Recurrent Laryngeal Nerve

Balkan Med J. 2024 Jul 5;41(4):280-285. doi: 10.4274/balkanmedj.galenos.2024.2024-2-2. Epub 2024 Jun 10.

Abstract

Background: Although several surgical landmarks have been proposed to localize the recurrent laryngeal nerve (RLN), there is still no reliable landmark.

Aims: To validate the reliability of a novel reference point at the intersection of the inferior border of the cricopharyngeal muscle and the inferior cornu of thyroid cartilage for locating the RLN.

Study design: Cadaver dissection study in the academic department of otolaryngology-head and neck surgery.

Methods: Sixty-four RLNs in cadavers were assessed, and measurements of different surgical landmarks in conjunction with the proposed surgical landmark were obtained. Descriptive statistics, Pearson’s chi-squared test, and Student’s t-test were performed to analyze the data using GraphPad Prism (version 9.4.1; Dotmatics, Boston, Massachusetts, USA).

Results: The average distance from the proposed landmark to the RLN was 2.3 ± 0.85 mm. The RLN was located just posterior to the reference point in 95.31% of the cadavers. The RLN passed under the inferior constrictor muscle in 90.63% of the cadavers. There was no statistically significant difference between right- and left-sided RLNs in terms of their relation with the reference point.

Conclusion: The proposed reference point can be used as a reliable landmark to locate the RLN. This reference point may help surgeons during difficult thyroidectomy surgeries by providing an additional anatomical landmark.

MeSH terms

  • Aged
  • Anatomic Landmarks
  • Cadaver*
  • Dissection / methods
  • Female
  • Humans
  • Male
  • Recurrent Laryngeal Nerve* / abnormalities
  • Recurrent Laryngeal Nerve* / anatomy & histology
  • Recurrent Laryngeal Nerve* / surgery
  • Reproducibility of Results