A Novel Surgical Landmark to Identify the Recurrent Laryngeal Nerve (Identifying Recurrent Laryngeal Nerve)

Abstract

Abstract Objective There are many surgical landmarks have been proposed to localize the recurrent laryngeal nerve (RLN). However, there is still no reliable landmark to find the RLN precisely. The objective was to use the inferior border of the cricopharyngeal muscle and the ICTC to define a reliable landmark for the RLN. Methods Cadaver dissection study in an Academic Otolaryngology-Head and Neck Surgery Residency Training Program. A cadaveric study of 64 RLNs was carried out, including measurements of different surgical landmarks in conjunct to proposed surgical landmark (Dundar’s point). Results The average distance from the reference point to the RLN is 2.3mm and the RLN is localized just posterior to the reference point in 95.3% of dissection specimens. The RLN passes under the inferior constrictor muscle in 90.6% of the cases. There was no statistically significant difference between right and left RLNs in term of relation with the reference point. Conclusions The proposed surgical point can be used as a reliable landmark to identify the RLN. This reference point can help surgeons during difficult cases by providing additional anatomical landmark. Level of Evidence: IV