Search

The objective of the present work was to investigate the laryngeal branching pattern of the inferior laryngeal nerve (ILN) in detail before the branches entered the larynx. In 49 specimens 96 sides were examined for this project, including 27 males and 22 female cadavers. In 7 sides (7.3%, 5 on the left and 2 on the right) the ILN passed as a single trunk into the larynx below the inferior constrictor muscle. In 82 sides (85.4%, 40 on the left and 42 on the right) two laryngeal branches originated from the nerve. The nerve divided either just before entering the larynx (58.3%, 24 on the left and 32 on the right) or 15–32 mm below the inferior constrictor muscle (27.1%, 16 on the left and 10 on the right). In 69 sides (71.8%), the anterior and/or posterior laryngeal branches subdivided into one or two sub-branches. The anterior (observed in 49 sides, 51%) and posterior laryngeal branches supplied all intrinsic laryngeal muscles except the cricothyroid muscle and the mucosa below the vocal cords, respectively, while their sub-branches reached the cricopharyngeal part of the inferior constrictor muscle, esophagus and/or the thyroid gland. In 7 sides (7.3%, 4 on the left and 3 on the right) the nerve divided into three laryngeal branches. In conclusion, the branching pattern of the nerve may be important pitfalls of the thyroidal and laryngeal surgery. Owing to this the surgeon should keep in mind the risk of extra laryngeal division of the nerve and not confuse laryngeal and extra laryngeal branches. [ABSTRACT FROM AUTHOR]

Background: Studies about the anatomic relationship between the inferior laryngeal nerve (ILN) and the ligament of Berry are insufficient, despite controversy in the literature. In addition, the relationship between the laryngeal branches of the ILN and the ligament of Berry has not been investigated. Study design: Sixty specimens (120 sides) were examined for this study, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. Results: The nerve trunk or its anterior and posterior laryngeal branches run posterolateral to the ligament in 51 and 39 sides, respectively. The nerve trunk or both its laryngeal branches passed posteromedial to the ligament in 12 and 7 sides, respectively. In seven sides, the anterior branch of the ILN was located posterolateral and the posterior branch was posteromedial to the ligament. In three sides, the anterior (motor) branch of the ILN penetrated the ligament of Berry. In one right side, a nonrecurrent laryngeal nerve arose from the vagal nerve at the level of ligament of Berry. The nerve divided into the anterior and posterior laryngeal branches just above posterior surface of the ligament; both branches extended parallel to it. Conclusions: We have shown that the nerve was located not only posterolateral to the ligament but also posteromedial to it. Additionally, unlike other authors, we have shown that the anterior (motor) branch of the recurrent laryngeal nerve penetrated the ligament of Berry in 2.5% of 60 specimens. [Copyright &y& Elsevier]

Background: Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve. Method: In 60 specimens, 102 sides were examined for this project, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. Results: In two sides (one on the right and the other on the left), we found that the anterior (motor) laryngeal branch of the inferior laryngeal nerve penetrated the ligament unilaterally. The branch entered the ligament 5.6, 7.2 mm above its lower border and 3.3, 1.9 mm below its upper border. Distances from the entrance point of the branch to the trachea and thyroid were 9.5, 8.2 mm and 3.1, 2.2 mm, respectively. Conclusion: We found two anterior laryngeal branches penetrating the ligament of Berry. This subject is very important during the thyroid surgery, particularly during the division of the ligament for total lobectomy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on extralaryngeal bifurcation of the recurrent laryngeal nerve by T. Beneragama and J. W. Serpell, published in a previous issue of this periodical.