Brandon Michael Henry1,2, Jens Vikse1,2, Matthew J Graves1,2, Silvia Sanna3, Beatrice Sanna4, Iwona M Tomaszewska5, Wan Chin Hsieh1,6, R Shane Tubbs7, Krzysztof A Tomaszewski1,2. 1. International Evidence-Based Anatomy Working Group, Krakow, Poland. 2. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland. 3. Department of Surgical Sciences, University of Cagliari, Sardinia, Italy. 4. Faculty of Medicine and Surgery, University of Cagliari, Sardinia, Italy. 5. Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland. 6. First Faculty of Medicine, Charles University, Prague, Czech Republic. 7. Seattle Science Foundation, Seattle, Washington.
Abstract
BACKGROUND: The relationship between the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA) is highly variable and traceable back to embryological life. METHODS: Comprehensive database searches were conducted, followed by judgment of eligibility, assessment, and extraction of data concerning the RLN/ITA relationship. The data were pooled into a meta-analysis and subjected to sex, side-based, geographic origin of study, and study modality subgroup analyses. RESULTS: Seventy-nine studies (n = 14,269 nerves) reported data on the relationship of the RLN to the ITA. The left versus right-sided comparison revealed stark differences: RLNs were predominantly posterior (62.6% vs 37.0%) and anterior (17.2% vs 37.1%) on the left and right sides, respectively. CONCLUSION: Symmetry of neurovascular relationships should not be assumed. Extra care should be taken during procedures on the right side, because the nerves are significantly more likely to present in patterns (anterior and between) associated with greater risk of iatrogenic injury.
BACKGROUND: The relationship between the recurrent laryngeal nerve (RLN) and inferior thyroid artery (ITA) is highly variable and traceable back to embryological life. METHODS: Comprehensive database searches were conducted, followed by judgment of eligibility, assessment, and extraction of data concerning the RLN/ITA relationship. The data were pooled into a meta-analysis and subjected to sex, side-based, geographic origin of study, and study modality subgroup analyses. RESULTS: Seventy-nine studies (n = 14,269 nerves) reported data on the relationship of the RLN to the ITA. The left versus right-sided comparison revealed stark differences: RLNs were predominantly posterior (62.6% vs 37.0%) and anterior (17.2% vs 37.1%) on the left and right sides, respectively. CONCLUSION: Symmetry of neurovascular relationships should not be assumed. Extra care should be taken during procedures on the right side, because the nerves are significantly more likely to present in patterns (anterior and between) associated with greater risk of iatrogenic injury.
Authors: George Noussios; Iosif Chatzis; Sergios Konstantinidis; Eva Filo; Antigone Spyrou; George Karavasilis; Anastasios Katsourakis Journal: J Clin Med Res Date: 2020-09-21