PURPOSE: The mechanism of left recurrent laryngeal nerve palsy after cervical mediastinoscopy remains unclear. Our aim is to describe the anatomical bases of this complication. METHODS: Video-assisted mediastinoscopy was performed on ten fresh human cadavers with simultaneous dissection of the left recurrent nerve. RESULTS: Three dissection areas could be described regarding the risk of left recurrent nerve damage: a low risk area, along the right wall and before the upper part of the anterior wall of the trachea; an area at high risk of indirect stretch-induced lesions, between the lower part of the anterior wall of the trachea and the aorta; -an area at high risk of direct injury, against the lower part of the left wall of the trachea. CONCLUSIONS: Dissection between the trachea and the aorta causes traction on the left recurrent nerve. Indirect stretch-induced injury is probably a frequent mechanism of left recurrent nerve palsy during mediastinoscopy.
PURPOSE: The mechanism of left recurrent laryngeal nerve palsy after cervical mediastinoscopy remains unclear. Our aim is to describe the anatomical bases of this complication. METHODS: Video-assisted mediastinoscopy was performed on ten fresh human cadavers with simultaneous dissection of the left recurrent nerve. RESULTS: Three dissection areas could be described regarding the risk of left recurrent nerve damage: a low risk area, along the right wall and before the upper part of the anterior wall of the trachea; an area at high risk of indirect stretch-induced lesions, between the lower part of the anterior wall of the trachea and the aorta; -an area at high risk of direct injury, against the lower part of the left wall of the trachea. CONCLUSIONS: Dissection between the trachea and the aorta causes traction on the left recurrent nerve. Indirect stretch-induced injury is probably a frequent mechanism of left recurrent nerve palsy during mediastinoscopy.
Authors: M Filaire; J M Garçier; Y Harouna; S Laurent; T Mom; A Naamee; G Escande; G Vanneuville Journal: Surg Radiol Anat Date: 2001 Impact factor: 1.246
Authors: Anthony Lemaire; Ivana Nikolic; Thomas Petersen; Jack C Haney; Eric M Toloza; David H Harpole; Thomas A D'Amico; William R Burfeind Journal: Ann Thorac Surg Date: 2006-10 Impact factor: 4.330