Imaging of the recurrent laryngeal nerve

Abstract

Recurrent laryngeal nerve (RLN) preservation is critical in both parathyroid and thyroid surgery. RLN imaging can determine both the location and trajectory relative to key cervical structures. In this chapter, we present an overview of nerve imaging methods using Magnetic Resonance Imaging (MRI). We highlight key techniques that enable the resolution required to image small nerves, such as the facial and cranial nerves. Furthermore, we discuss the challenges involved in RLN imaging and present preliminary MRI results using a novel phase-navigated T2-Turbo Spin-Echo and Constructive Interference in Steady-State sequences. Ultimately, preoperative MRI images can guide surgical planning or be used with a navigation system during surgery to localize and preserve the RLN in real-time.