Exploring the anatomical relationship between the recurrent laryngeal nerve and the inferior thyroid artery: insights from cadaveric dissections

Abstract

Injury to Recurrent Laryngeal Nerve (RLN) is the most common complication of surgical interventions for thyroid gland disorders. This makes a thorough anatomical knowledge of RLN with variations in its branching pattern and relationship with Inferior Thyroid Artery (ITA) of vital importance for surgeons. The current study was aimed to establish the relationship of RLN with Inferior Thyroid Artery (ITA) as well as its implications on thyroid surgeries. We studied the 73 RLN during routine dissection and autopsy examinations through a lateral approach and observations were tabulated using descriptive statistics and relational statistics, Chi-square test, for analysing significance. The results showed statistically significant differences in RLN branching patterns as well as in its positions relative to ITA between the right and left RLN. Extra-laryngeal terminal bifurcations were the most common finding and posterior positioning of RLN with respect to ITA was predominant. More so, bifurcations occurred more frequently on the right side (75.67%) than on the left side (30.55%) (P < 0.05). The nerve was observed posterior to the ITA in 78.08%, anterior in 24.65% and in-between in 5.47% specimens. The potential consequences of such RLN variations on surgical outcomes emphasize the risk of iatrogenic injuries and associated symptoms. We also noted discrepancies in findings compared to a previous few studies, but these may be attributed to the embryological and racial differences. The study underscores the importance of understanding RLN anatomy for safe thyroid surgeries and warrant further research to elucidate RLN variations and their impact on surgical procedures contributing valuable insights into RLN anatomy to optimize surgical outcomes and reduce complications in thyroid surgeries.