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Article Abstract

Non-recurrent inferior laryngeal nerve (NRILN) is a rare embryologic anomaly that can increase the risk of injury during thyroid surgery. Although the association between the NRILN and an aberrant right subclavian artery has been reported, to date there have been no reports describing cases of NRILN with multiple vascular abnormalities. A 60-year-old man with papillary thyroid carcinoma and a history of right internal carotid artery occlusion by thrombosis was examined with magnetic resonance angiography (MRA). The right NRILN was found during a total thyroidectomy with surrounding lymph node dissection. MRA revealed an aberrant right subclavian artery and aplasia of the bilateral posterior communicating arteries composing the circle of Willis. This is the first clinical report demonstrating NRILN with multiple vascular abnormalities. Patients with NRILN must be examined for vascular anomalies and associated lesions such as aneurysms and thromboembolism.

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http://dx.doi.org/10.1080/00016480600801415DOI Listing

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Article Synopsis
  • The nonrecurrent laryngeal nerve (NRLN) is a rare variation of the recurrent laryngeal nerve with a prevalence of 0.3-0.8% on the right side and only 0.004% on the left.
  • A case study of a young woman with a thyroid mass revealed a NRLN during surgery, as imaging indicated vascular anomalies associated with the lesion.
  • The authors emphasize the importance of identifying NRLN during thyroid surgery to prevent nerve injury, especially when preoperative imaging suggests vascular irregularities.
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Complete and precise knowledge of the neck anatomy and its eventual anomalies is crucial while performing a safe thyroid and parathyroid surgery. Embryo-genetic malformations of the IV branchial arch can lead to an uncommon anatomical alteration known as non-recurrent inferior laryngeal nerve. Its prevalence varies between 0.

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