Course of the recurrent laryngeal nerve relative to the inferior thyroid artery and the suspensory ligament of Berry.

An awareness of the surgical anatomy and the possible dispositions of the recurrent laryngeal nerve (RLN) is very helpful in avoiding its injury during thyroidectomy. The relationship of the RLN to the inferior thyroid artery (ITA) and the suspensory ligament of Berry were studied in 172 patients undergoing thyroidectomy. One hundred and ninety one nerves were identified, 109 on the right and 82 on the left. Most nerves, both on the right (82.6%) as well as on the left (85.4%) ran either posterior or between the branches of the inferior thyroid artery. The majority of nerves were found within 3 mm from Berry's ligament. The relationship of the recurrent laryngeal nerve to the inferior artery and to the ligament of Berry does not follow a constant anatomical pattern. Nevertheless these structures have a quite close relationship to the nerve in the majority of cases.