Applied Anatomy Of The Recurrent Laryngeal Nerve And Its Branches Of Thyroid Surgery Area Dog Recurrent Laryngeal Nerve Loop Morphology And Fiber Properties To Identify

Objective: To provide an anatomic basis for the location and protection of the recurrent laryngeal nerve ( RLN ) and its branches in the thyroid surgery.Methods: 100 adult cadavers (200 sides) fixed with formalin were collected at random for study. The RLN and its branches were dissected, observed and measured in the region of thyroid surgery.Results: In the group all RLNs bifurcated into the laryngeal branch and extra-laryngeal branch. The former usually divided into the anterior branch and posterior branch before entering the larynx. Like a tree, 87% of the RLNs gave off several branches, which were called multiple-branch type. The incidence of RLN loop(loop type), connecting one branch to another and ( or ) cervical sympathetic chain, was 13.0%(13 out Of 100 sides). 59.8% of the branches divided above the level of the inferior pole of the lateral lobe of the thyroid gland, the pointswhere the branches gave off were about( 10.1 + 7.2) mm away from the level of the inferior pole of the thyroid gland, 8.5% of branches divied on the level of the inferior pole of the thyroid gland, and 31.7% of the branches divided under it and the distance was(8.6 + 5.5) mm. On the right side, the RLN was in front of the inferior thyroid artery in 50% of the cases, behind the artery in 22%; among the branches of the artery in 14%, 14% the branches of both nerves and artery were interlaced that the relationship between the branches of the nerve and the artery was uncertain. On the left side, the RLN was behind the artery in 56%, in front of the artery in 14%. The nerve was between branches in 16%, and was among the combined in 14%.Conclusion: To protect RLN from injury in thyroid surgery, it is necessary to separate inferior thyroid artery and its branches from the RLN (or the RLN loop) and its branches before the former are ligated.