Non-recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review

Emmanouil Bakalinis, Ioannis Makris, Theano Demesticha, Georgios Tsakotos, Panagiotis Skandalakis, Dimitrios Filippou


Objective. The purpose of this paper is to review the current data on the coexistence of non-recurrent laryngeal nerve (RLN) and vascular variations.

Methods. A systematic literature search was conducted on MEDLINE for case reports, original articles and reviews regarding the presence of non-RLN and coexisting vascular variants.

Results. From the literature search, 104 cases of non-RLN with confirmed vascular variants were reported. More specifically, 97.7% (n=101) of cases involved a right and 2.3% (n=3) a left non-RLN. The most common concurrent vascular variant reported with a right non-RLN was an aberrant right subclavian artery (97%; n=98). One case report (0.9%) of an intrathyroidal right common carotid artery was noted and 2 cases (1.9%) were associated with normal vascular anatomy. Furthermore, all 3 cases of a left non-RLN were associated with a right aortic arch, while 2 of them were also accompanied with situs inversus.

Conclusions. The presence of vascular variations of the great vessels must prompt the surgeon to search for a non-RLN. Intraoperative neuromonitoring increases the detection rate of non-RLN. Further research is required to determine anatomic landmarks for the perioperative identification of a non-RLN, allowing its protection from potential injury.


Thyroidectomy; Recurrent Laryngeal Nerve; Variant; Aberrant Right Subclavian Artery

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