Intrathoracic blood supply of the left vagus and recurrent laryngeal nerves

The arteries and veins of the left vagus (VN) and left recurrent laryngeal (RLN) nerves from the thoracic inlet to the subaortic region are described following vascular casting with red colored latex in 6 adult fresh non-emba lmed cadavers. In all specimens the anterior bronchoesophageal artery suppl ied at least one vessel to the VN and RLN in the subaortic region. For the RLN other arterial sources were arteries arising from the aortic arch in 1 specimen, the subclavian artery in 3 specimens, the first intercostal arter y in 1 specimen, and the inferior thyroid artery in all specimens. For the VN other arterial sources were arteries arising from the aortic arch in 2 s pecimens and the inferior thyroid artery in 1 specimen. For both the VN and RLN the veins were located under the pleura and directed towards the inter nal thoracic vein anteriorly and the thoracic intercostal veins posteriorly . In conclusion, the inferior thyroid artery at the thoracic inlet for the RLN and the anterior bronchoesophageal artery are the more consistent vesse ls supplying the VN and RLN. Vascular damage occurring during mediastinal l ymph node excision to the VN and RLN, especially in the subaortic region, m ay explain postoperative vocal fold paralysis.