Nonrecurrent laryngeal nerves: Anatomic considerations during thyroid and parathyroid surgery

Purpose: In head and neck surgery, damage to the recurrent laryngeal nerve (RLN) during thyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the RLNs and meticulous surgical technique can significantly decrease the incidence of this complication. Nonrecurrent RLNs (NRRLNs) are exceedingly rare. Surgeons need to be aware of their position to avoid damage to them. Materials and Methods: A retrospective review of 513 RLN exposures over a 7-year period was performed. Results: Two NRRLNs were encountered, for an incidence of 0.39%, Conclusion: NRRLNs are rare. Awareness of their existence will prevent the surgeon from accidentally severing one if it is encountered during routine thyroid or parathyroid surgery. (Am J Otolaryngol 1999,20:91-95. Copyright (C) 1999 by W.B. Saunders Company).