Nonrecurrent laryngeal nerve in thyroid surgery: Frequency, anatomical variations according to a new classification and surgery consideration.

Abstract

The nonrecurrent laryngeal nerve (NRLN) is a rare embryologically derived variant of the RLN. We aimed to identify the proportion of NRLN (during thyroidectomy), classify clinical NRLN types, and recommend some surgical considerations. In this prospective study, from May 2017 to September 2018, our hospital carried out 2158 thyroid operations. We reported the NRLN rate and distinguished NRLN into four types. Overall, NRLN had an incidence rate of 0.74% (16 out of 2158 total thyroid surgeries). We did not detect any patient with left-sided NRLN. The traveling patterns of the nerves could be classified as descending (12.5%), vertical (25%), ascending (37.5%), or V-shaped (25%). The NRLN is a rare variation of the RLN. From our experience, we recommend the guidelines will help surgeons to avoid NRLN injury.