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Doctoral Thesis | Otorhinolaryngology | India | Volume 12 Issue 2, February 2023 | Rating: 5 / 10
Surgical Anatomy of Recurrent Laryngeal Triangle of Neck Seen under Microscope during Thyroid Surgery-Judicious Option
Dr. Shivani Dixit | Dr. Arun Dehadaray | Dr. Maitri Kaushik
Abstract: Background and Aim: Thyroid surgeries require in-depth knowledge of recurrent laryngeal triangle. It is well known that variation of RLN is prone to iatrogenic injuries due to its various anatomical variation. Injury to recurrent laryngeal nerve (RLN) is one of the major risks of thyroid surgery. Visual identification of RLN remains the gold standard for prevention of RLN injury. We Aimed to understand detailed anatomy of recurrent laryngeal triangle using microscope during thyroid surgery so that injury to vital structure can be prevented and thus complication can be reduced improving quality of life of patient post operatively. Materials and Method: This was an intraoperative observational study conducted on 24 patients who underwent thyroid surgeries exclusively using 200x lens microscope between period (October 2019-October 2021). Anatomical variation of RLN and its relationship with inferior thyroid artery and blood supply to parathyroid gland were observed. Postoperatively nerve palsy and hypocalcemia were assessed. All the observational findings were noted. Results: Total 29 Recurrent laryngeal nerve was seen in 24 patients, on both sides majority of cases showed type 1 anatomical variation (extra laryngeal). In most of cases RLN was seen going below ITA and blood supply to parathyroids were observed coming from inferior thyroid artery. Out of 24 cases Only 1 case had transient hypocalcaemia and Vocal cord palsy. Conclusion: Microscope is great teaching tool and magnification tool. With help of microscope iatrogenic injuries to RLN and ITA can be prevented thus reducing postoperative complication and has excellent patient outcome.
Keywords: RLN, ITA, nerve palsy, hypocalcemia
Edition: Volume 12 Issue 2, February 2023,
Pages: 489 - 493