Clin Exp Otorhinolaryngol.  2017 Mar;10(1):104-108. 10.21053/ceo.2015.01746.

The Anatomical Relationship Between Recurrent Laryngeal Nerve and First Tracheal Ring in Males and Females

• Akil F
• Yollu U
• Ayral M
• Turgut F
• Yener M

• KMID: 2376416
• DOI: http://doi.org/10.21053/ceo.2015.01746

Abstract

OBJECTIVES
Despite the modern advances in thyroid surgery, recurrent laryngeal nerve (rln) paralysis is still a critical problem. In order to decrease the rate of this complication, rln anatomy has been studied intensively. In our study, we aimed to recognize the relationship of rln and landmarks of the first tracheal ring.
METHODS
Eighty-six female and 18 male patients who were undergone total thyroidectomy were included in this study. Trachea vertical height (tvh), right recurrent laryngeal nerve height (rrh), left recurrent laryngeal nerve height (lrh), right recurrent laryngeal nerve to trachea anterior face median raphe distance (rrd), left recurrent laryngeal nerve to trachea anterior face median raphe distance (lrd), right recurrent laryngeal nerve respect to trachea ratio (rrtr), and left recurrent laryngeal nerve respect to trachea ratio (lrtr) parameters of all patients were measured and compared in males and females using independent t-test and measurements on both right and left sides were compared statistically without sex discrimination.
RESULTS
There were no significant differences between groups in tvh, rrh, rrd, lrd, rrtr, and lrtr parameters. Lrh parameter was significantly higher in males than in females (P<0.04). Comparison of right and left sides revealed that lrh was significantly higher than rrh (P<0.001), lrd was significantly higher than rrd (P<0.001), and rrtr was significantly higher than lrtr (P<0.001).
CONCLUSION
In this study, we have shown that in all cases the rln was located around the lower half of trachea vertical length and at this level left rln was located significantly deeper than the right side.

Keyword

Recurrent Laryngeal Nerve; Thyroidectomy; Intraoperative Complications; Trachea; Anatomy

MeSH Terms

Female*
Humans
Intraoperative Complications
Male*
Paralysis
Recurrent Laryngeal Nerve*
Sexism
Thyroid Gland
Thyroidectomy
Trachea

Figure

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  Fig. 1. Demonstration of tracheal axial section at first tracheal ring level. Distance of recurrent laryngeal nerve to trachea midline is (right recurrent laryngeal nerve to trachea anterior face median raphe distance and left recurrent laryngeal nerve to trachea anterior face median raphe distance) demonstrated by blue, recurrent vertical height (right recurrent laryngeal nerve height and left recurrent laryngeal nerve height) is red and trachea vertical height is yellow arrows. Dotted grey lines demonstrated the tracheal midline, top point of the vertical projection of trachea and the vertical level of recurrent laryngeal nerve.

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