Intraoperative Study of 1988 Recurrent Laryngeal Nerves

Objective To study the anatomical relationship between the recurrent laryngeal nerve(RLN)and the inferior thyroid artery,to investigate the prophylactic measures on how to avoid iatrogenic injures while exposing the RLN during thyroid operation.Methods Retrospectively reviewed the clinical data of 1 345 patients accepted thyroid operation with RLN exposing.Results A total of RLN 1 988 were observed,874 on the left and 1 114 on the right(including 2 non-recurrent laryngeal nerve).On the left side,the nerve passed anterior to the artery in 32.8%,posterior to it in 26.7%,and between the branches of the artery in 41.6%.On the left side,the nerve was found coursing anterior to the artery in 36.2%,posterior to it in 28.2%,and between the branches in 35.3%.6 nerves were iatrogenic injured,4 cases were temporary injured and 2 were permanent.Conclusions Although the anatomical relationship between the RLN and the inferior thyroid artery are variable,iatrogenic injures of the nerve can be avoid by exposing it,and an experienced surgeon with good knowledge of RLN anatomical characteristics and skilled surgical techniques was needed.