The recurrent laryngeal nerve and extralaryngeal branches in relation to the inferior thyroid artery, Berry’s ligament, tracheal groove, and Zuckerkandl tubercle: an experience of 60 thyroidectomies

Abstract

Aim: The aim of this study was to examine the anatomical variations of the inferior laryngeal nerve compared with its extralaryngeal branches, the inferior thyroid artery, Berry’s ligament, the tracheal groove, and the tubercle of Zuckerkandl, as encountered during thyroid gland operations. This is a case series conducted at the Anticancer Hospital of Thessaloniki “Theageneio” between October 2021 and May 2022. Materials and methods: Sixty patients underwent thyroidectomy under general anesthesia using a standardized surgical dissection technique by a single surgeon. In all cases, the extralaryngeal part of the inferior laryngeal nerve was identified and its anatomical relation were recorded. Results: The most frequently found locations for the inferior laryngeal nerve were in the tracheal groove (66.4%), superficial to the ligament of Berry (77.6%), posterior to the tubercle of Zuckerkandl (69.2%), and posterior to the inferior thyroid artery (56.1%). Additionally, the inferior laryngeal nerve was predominantly with no branches in its extralaryngeal part (62.9%). Conclusion: The study emphasizes the importance of a careful inferior laryngeal nerve identification in order to minimize the risk of injury and to ensure the safety and well-being of the patients.