Location of RLN
using different landmarks have been proposed which includes Simon's triangle in relation with inferior thyroid artery at inferior pole of thyroid gland.
Conclusion: Frequency of RLN
injury was almost 5% as whole in thyroid surgery but rate was more in complicated cases like thyroid carcinoma, recurrent goiter and hyperthyroid goiter because of altered anatomy.
Although there are advocates that careful dissection does not increase nerve damage, currently many authors suggest that RLN
is very susceptible to surgical dissection and that minimal dissection should be performed since dissection throughout its tract will put the nerve at greater risk (4, 5).
This is because the risk of complication is complete if both lobes along with the important paired organs - parathyroid gland, RLN
, and external branch of the Superior Laryngeal Nerve (SLN)--are all subjected to the same extent of dissection.
Application of carbon nanoparticles suspensions injection can stain the lymph nodes of the center compartment while leaving the parathyroid glands unstained (because of the negative development of parathyroid glands to carbon nanoparticles, Chongqing Lummy Pharmaceuticals, China), thus helping to identify and protect parathyroid glands and the RLN
[Figure 3] and [Figure 4], as well as facilitating the identification and clearance of lymph nodes.
2,11,22) In contrast, unilateral RLN
injuries are often treated with medialization procedures if conservative management outcomes are suboptimal.
provides motor innervation to all intrinsic laryngeal muscles except the cricothyroid muscle, which receives motor innervation from the external branch of the SLN (EBSLN).
The authors of some recent studies proposed that RLN
metastasis independent of laterality be classified as N1 disease, (8-10) which led to the refinement of the 7th edition of the American Joint Committee on Cancer (AJCC) staging system.
Postoperative voice change independent of RLN
injury had been compared in 5 studies [22, 27,39,45,47].
can be damaged as result of external trauma which may occur due to external compression, bullet injury, mine blasts, strangulation cases.
From Table I and Table II, the values of GLN and RLN
features are mutually overlapped between the scripts.
9 Similarly, if RLN
palsy persited for over six months, it was considered permanent.