Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review

Deborah Ongaro; Stefano Elia; Roberto Cazzaniga; Lucio Taglietti

doi:doi:10.11648/j.ijcts.20160204.14

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Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review

Deborah Ongaro, Stefano Elia, Roberto Cazzaniga, Lucio Taglietti

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 2, Issue 4)

Received: 5 October 2016 Accepted: 29 November 2016 Published: 21 December 2016

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Abstract

The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 2, Issue 4)
DOI	10.11648/j.ijcts.20160204.14
Page(s)	29-33
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Non-recurrent Laryngeal Nerve, Carotid Endarterectomy, Aberrant Subclavian Artery, Cranial Nerves Injury, Neurological Complications

References

[1]	Toniato A, Mazzarotto R, Piotto A, Bernante P, Pagetta C, Pelizzo MR. Identification of the nonrecurrent laryngeal nerve during thyroid surgery: 20 year-experience. Word J Surg. 2004; 28 (7) 659-61.
[2]	Coady MA, Adler F, Davila JJ, Gahtan V. Nonrecurrent laryngeal nerve during carotid artery surgery: Case report and literature review. J Vasc Surg. 2000; 32: 192-6.
[3]	Henry JF, Audiffret J, Denizot A, Plan M. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988; 104: 977-83.
[4]	Fellmer PT, Böhner H, Wolf a, Röher HD, Goretzki PE. A left non-recurrent inferior laryngeal nerve in a patient with right-sided aorta, truncus arteriosus communis, and an aberrant left innominate artery. Surg Radiol Anat. 2008; 25: 263-69.
[5]	Stedman GW. A singular distribution of some of the nerves and arteries of the neck and the top of thorax. Edin Med and Surg J. 1823; 19: 564-5.
[6]	Hart J. A case of irregular origin and course of the right subclavian and right inferior laryngeal nerve. Edin Med Surg J. 1826; 25: 286.
[7]	Hilton J. On the distribution and probable function of the superior and the recurrent laryngeal nerves as demonstrated by dissection in the human subject. Guys Hosp Rep. 1837; 2: 514.
[8]	Pemberton JD, Beaver MG. Anomaly of the right recurrent laryngeal nerve. Surg Gynecol Obstet. 1932; 54: 594-5.
[9]	Monahan TS. Nonrecurrent inferior laryngeal nerve. Vasc Endovascular Surg. 2011; 45: 90-1.
[10]	Avisse C, Marcus C, Delattre JF, Marcus C, Cailliez-Tomasi JP, Palot JP, et al. Right nonrecurrent inferior laryngeal nerve and arteria lusoria: the diagnostic and therapeutic implications of an anatomic anomaly. Surg Radiol Anat. 1998; 20: 227-32.
[11]	Langman’s medical embryology. Sadler, T W. 2016, 12^th edition.
[12]	Page C, Monet P, Peltier J, Bonnaire B, Strunski V. Non-recurrent laryngeal nerve related to thyroid surgery: report of three cases. J Laryngol Otol. 2008; 122: 757-61.
[13]	Kato K, Toriumi Y, Kamio M, Nogi H, Shioya H, Takeyama H. Nonrecurrent inferior laryngeal nerves and anatomical findings during thyroid surgery: report of three cases. Surg Case Reports. 2016; 2: 44.
[14]	Kobayashi M, Yuta A, Okamoto K, Majima Y. Non-recurrent inferior laryngeal nerve with multiple arterial abnormalities. Acta Otolaryngol. 2007; 127: 332-36.
[15]	Kato A, Yamada H, Yamada T, Matsuura T. Non-recurrent inferior laryngeal nerve in three patients with thyroid cancer. J Jpn Bronchoesophagol Soc. 1996; 47: 318-24.
[16]	Tateda M, Hasegawa J, Sagai S, Nakanoma A, Katagiri K, Ishida E, et al. Nonrecurrent inferior laryngeal nerve without vascular anomaly as a genuine entity. J Exp Med. 2008; 216: 133-37.
[17]	Raffaeli M, Iacobone M, Henry JF. The “false” nonrecurrent inferior laryngeal nerve. Surgery. 2000; 128: 1082-87.
[18]	Yetişir F, Salman E, Özkardeş AB, Aydin SM, Kiliҫ M. Fusion of cervical sympathetic ganglion with the recurrent inferior laryngeal nerve: a case of false positive non-recurrent inferior laryngeal nerve. Ulusal Cer Derg. 2013. 29: 150-2.
[19]	Calzolari F, Misso C, Monacelli M, Lucchini R, Sanguinetti A, d’Ajello M, et al. Non-recurrent inferior laryngeal nerves and sympathetic-inferior laryngeal anastomotic branches: 6 years personal experience. Chir Ital. 2008; 2: 221-25.
[20]	Raffaeli M, Iacobone M, Henry JF. The “false” nonrecurrent inferior laryngeal nerve. Surgery. 2000; 128: 1082-87.
[21]	Thompson NW. In discussion of Henry et al. Surgery. 1998; 104: 977-84.

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APA Style

Deborah Ongaro, Stefano Elia, Roberto Cazzaniga, Lucio Taglietti. (2016). Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. International Journal of Cardiovascular and Thoracic Surgery, 2(4), 29-33. https://doi.org/10.11648/j.ijcts.20160204.14

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ACS Style

Deborah Ongaro; Stefano Elia; Roberto Cazzaniga; Lucio Taglietti. Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. Int. J. Cardiovasc. Thorac. Surg. 2016, 2(4), 29-33. doi: 10.11648/j.ijcts.20160204.14

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AMA Style

Deborah Ongaro, Stefano Elia, Roberto Cazzaniga, Lucio Taglietti. Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. Int J Cardiovasc Thorac Surg. 2016;2(4):29-33. doi: 10.11648/j.ijcts.20160204.14

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@article{10.11648/j.ijcts.20160204.14,
  author = {Deborah Ongaro and Stefano Elia and Roberto Cazzaniga and Lucio Taglietti},
  title = {Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {2},
  number = {4},
  pages = {29-33},
  doi = {10.11648/j.ijcts.20160204.14},
  url = {https://doi.org/10.11648/j.ijcts.20160204.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20160204.14},
  abstract = {The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.},
 year = {2016}
}

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TY  - JOUR
T1  - Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review
AU  - Deborah Ongaro
AU  - Stefano Elia
AU  - Roberto Cazzaniga
AU  - Lucio Taglietti
Y1  - 2016/12/21
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DO  - 10.11648/j.ijcts.20160204.14
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 29
EP  - 33
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20160204.14
AB  - The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.
VL  - 2
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Author Information

Deborah Ongaro

Department of Surgery, University of Brescia, Brescia, Italy
Stefano Elia

Department of Radiology, Esine Hospital, Brescia, Italy
Roberto Cazzaniga

Department of Surgery, Esine Hospital, Brescia, Italy
Lucio Taglietti

Department of Surgery, Esine Hospital, Brescia, Italy

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APA Style

Deborah Ongaro, Stefano Elia, Roberto Cazzaniga, Lucio Taglietti. (2016). Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. International Journal of Cardiovascular and Thoracic Surgery, 2(4), 29-33. https://doi.org/10.11648/j.ijcts.20160204.14

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ACS Style

Deborah Ongaro; Stefano Elia; Roberto Cazzaniga; Lucio Taglietti. Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. Int. J. Cardiovasc. Thorac. Surg. 2016, 2(4), 29-33. doi: 10.11648/j.ijcts.20160204.14

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AMA Style

Deborah Ongaro, Stefano Elia, Roberto Cazzaniga, Lucio Taglietti. Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review. Int J Cardiovasc Thorac Surg. 2016;2(4):29-33. doi: 10.11648/j.ijcts.20160204.14

Copy | Download

@article{10.11648/j.ijcts.20160204.14,
  author = {Deborah Ongaro and Stefano Elia and Roberto Cazzaniga and Lucio Taglietti},
  title = {Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {2},
  number = {4},
  pages = {29-33},
  doi = {10.11648/j.ijcts.20160204.14},
  url = {https://doi.org/10.11648/j.ijcts.20160204.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20160204.14},
  abstract = {The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.},
 year = {2016}
}

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TY  - JOUR
T1  - Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review
AU  - Deborah Ongaro
AU  - Stefano Elia
AU  - Roberto Cazzaniga
AU  - Lucio Taglietti
Y1  - 2016/12/21
PY  - 2016
N1  - https://doi.org/10.11648/j.ijcts.20160204.14
DO  - 10.11648/j.ijcts.20160204.14
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 29
EP  - 33
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20160204.14
AB  - The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.
VL  - 2
IS  - 4
ER  -

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