Topographical Anatomy of External Branch of Superior Laryngeal Nerve as Related to thyroidectomy
Journal Title: Journal of Medical Science And clinical Research - Year 2016, Vol 4, Issue 11
Abstract
Background: The External branch of superior laryngeal nerve is intimately associated with the superior thyroid artery, and is vulnerable to injury during thyroidectomy. EBSLN supplies the cricothyroid muscle which is the tensor of vocal cord. Injury to this nerve can have catastrophic consequences in people who use their voice professionally. Variations of EBSLN anatomy make its intra operative assessment challenging. Aim: To describe the anatomic variations of the external branch of superior laryngeal nerve observed during thyroidectomy. Methods: Patients who underwent thyroidectomy from 2010 to 2016 at a tertiary care centre in North Malabar were included. Intra operatively the EBSLN was identified and the topographic anatomy in relation to the superior thyroid pedicle and upper pole of the thyroid gland were noted. Results: Total 406 thyroidectomy were analysed,. The nerve could be identified in 94.7% cases. Type IIa nerve was most commonly seen, and type IIb was the least. Fourth type nerve was not identified. Conclusion: Preservation of EBSLN is important in every thyroid surgery. During surgery the risk of nerve injury do exist, although injury rates are not clearly established. Type IIa variant of EBSLN is the commonest followed by type I. With careful medial dissection and lateralisation in Jolls triangle, EBSLN is easly identified. Identification and ligation of individual vessels in the superior pole in a bloodless back ground will prevent damage to the nerve. Surgeons should show greater awareness regarding the anatomical interpretation of EBSLN and its branches to reduce the incidence of iatrogenic nerve injury
Authors and Affiliations
Arun. S
Keywords
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