Akihito Watanabe1, Masanobu Taniguchi1, Yuki Kimura1, Suguru Ito2, Masao Hosokawa3, Shigeyuki Sasaki4. 1. Department of Otolaryngology - Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan. 2. Division of Voice Rehabilitation, Keiyukai Sapporo Hospital, Sapporo, Japan. 3. Department of Surgery, Keiyukai Sapporo Hospital, Japan. 4. Health Science University of Hokkaido, Ishikari-Tobetsu, Japan.
Abstract
BACKGROUND: The nonrecurrent inferior laryngeal nerve (NRILN) is always associated with the aberrant subclavian artery. CT images can detect this vascular anomaly, which predicts an NRILN. The purpose of this study was to report our procedure to identify the NRILN in patients with the aberrant subclavian artery. METHODS: Four of 730 patients undergoing thyroid operation in our hospital were preoperatively diagnosed with aberrant subclavian artery by CT of the neck. To avoid vocal cord paralysis, we approached the vagal nerve first before dissecting the paratracheal region to discover the separation point of the NRILN from the vagal nerve. RESULTS: The NRILN was identified without difficulty in all 4 patients. No patients showed vocal cord paralysis. CONCLUSION: Approaching the vagal nerve first before dissecting the paratracheal region is an efficient, effective, and safe procedure to identify an NRILN in patients who are preoperatively diagnosed as having the aberrant subclavian artery.
BACKGROUND: The nonrecurrent inferior laryngeal nerve (NRILN) is always associated with the aberrant subclavian artery. CT images can detect this vascular anomaly, which predicts an NRILN. The purpose of this study was to report our procedure to identify the NRILN in patients with the aberrant subclavian artery. METHODS: Four of 730 patients undergoing thyroid operation in our hospital were preoperatively diagnosed with aberrant subclavian artery by CT of the neck. To avoid vocal cord paralysis, we approached the vagal nerve first before dissecting the paratracheal region to discover the separation point of the NRILN from the vagal nerve. RESULTS: The NRILN was identified without difficulty in all 4 patients. No patients showed vocal cord paralysis. CONCLUSION: Approaching the vagal nerve first before dissecting the paratracheal region is an efficient, effective, and safe procedure to identify an NRILN in patients who are preoperatively diagnosed as having the aberrant subclavian artery.
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