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 c ord paralysis. Identification of the RLNs and meticulous surgical technique can significantly decrease the incidence of this complication. Nonrecurren t RLNs (NRRLNs) are exceedingly rare. Surgeons need to be aware of their po sition 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).