PURPOSE: Despite the intrathoracic part being short, the right laryngeal recurrent nerve is often injured during thoracic surgery. The aim of this cadaver study was to understand the mechanisms of right laryngeal recurrent nerve injuries during thoracic surgery and to describe anatomical landmarks for its preservation. METHODS: Dissections were performed on 10 fresh human cadavers. A right anterolateral thoracic wall segment was removed, preserving the first rib. Dissections were carried out to identify the following structures: first rib, esophagus, trachea, right main bronchus, right brachiocephalic and subclavian vessels, azygos vein, phrenic nerve, vagus nerve, and right laryngeal recurrent nerve. RESULTS: The distance between the origin of the right laryngeal recurrent nerve and its adjacent structures was assessed. Moderate traction of the thoracic part of the vagus nerve resulted in a downward translation of the right laryngeal recurrent nerve's origin. In such conditions, the right laryngeal recurrent nerve's origin was distant of 14.8 mm (±2.89 mm) from the subclavian artery. CONCLUSIONS: Intraoperative incidence of right laryngeal recurrent nerve direct injury could be decreased by understanding the detailed course of its intrathoracic part. Moreover, traction on the intrathoracic part of the right vagus nerve may result in indirect lesions of the right laryngeal recurrent nerve: stretch induced lesions and nerve vasculature's lesions.
PURPOSE: Despite the intrathoracic part being short, the right laryngeal recurrent nerve is often injured during thoracic surgery. The aim of this cadaver study was to understand the mechanisms of right laryngeal recurrent nerve injuries during thoracic surgery and to describe anatomical landmarks for its preservation. METHODS: Dissections were performed on 10 fresh human cadavers. A right anterolateral thoracic wall segment was removed, preserving the first rib. Dissections were carried out to identify the following structures: first rib, esophagus, trachea, right main bronchus, right brachiocephalic and subclavian vessels, azygos vein, phrenic nerve, vagus nerve, and right laryngeal recurrent nerve. RESULTS: The distance between the origin of the right laryngeal recurrent nerve and its adjacent structures was assessed. Moderate traction of the thoracic part of the vagus nerve resulted in a downward translation of the right laryngeal recurrent nerve's origin. In such conditions, the right laryngeal recurrent nerve's origin was distant of 14.8 mm (±2.89 mm) from the subclavian artery. CONCLUSIONS: Intraoperative incidence of right laryngeal recurrent nerve direct injury could be decreased by understanding the detailed course of its intrathoracic part. Moreover, traction on the intrathoracic part of the right vagus nerve may result in indirect lesions of the right laryngeal recurrent nerve: stretch induced lesions and nerve vasculature's lesions.
Authors: T Mom; M Filaire; D Advenier; C Guichard; A Naamee; G Escande; X Llompart; L Vallet; J Gabrillargues; C Courtalhiac; B Claise; L Gilain Journal: J Thorac Cardiovasc Surg Date: 2001-04 Impact factor: 5.209
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: M Filaire; T Mom; S Laurent; Y Harouna; A Naamee; L Vallet; B Normand; G Escande Journal: Eur J Cardiothorac Surg Date: 2001-10 Impact factor: 4.191
Authors: Judith Boone; Daan P Livestro; Sjoerd G Elias; Inne H M Borel Rinkes; Richard van Hillegersberg Journal: Dis Esophagus Date: 2009-01-23 Impact factor: 3.429
Authors: Brandon Michael Henry; Silvia Sanna; Matthew J Graves; Jens Vikse; Beatrice Sanna; Iwona M Tomaszewska; R Shane Tubbs; Jerzy A Walocha; Krzysztof A Tomaszewski Journal: PeerJ Date: 2017-03-21 Impact factor: 2.984