Associations among recurrent laryngeal nerve, inferior horn of thyroid cartilage, Berry's ligament and Zuckerkandl's tubercle.

During neck surgery, localizing and monitoring the nerve has become "sine qua non" rule in order to avoid damaging recurrent laryngeal nerve. Any anatomical structure should not be cut without seeing the nerve, single landmark should not be relied upon and branching differences should be taken into consideration. During the neck surgery; Zuckerkandl's tubercle, Berry's ligament, the inferior horn of thyroid cartilages has become crucial anatomical landmarks in order to protect the integrity of the recurrent laryngeal nerve. In this study, sixty sides of thirty male postmortem human cadavers obtained from Department of Anatomy, Akdeniz University was used. The proximal part of the recurrent laryngeal nerve, before the inferior thyroid artery arises from its source has been observed in 52 sides (87%) inside the tracheo-esophageal groove and in 8 sides (13%) running laterally to the trachea. The recurrent laryngeal nerve was encountered passing behind and through the branches of the inferior thyroid artery in 55 sides (92%) and 6 (8%) respectively. At all sides; the nerve was piercing the larynx 0.6±0.1 mm below the inferior horn of thyroid cartilage, passing next to the inner-lower side of Berry's ligament and running under the lower middle part of Zuckerkandl's tubercle. In conclusion, these landmarks and their upper mentioned distances to the laryngeal nerve can be taken into consideration as important surgical guides. [ABSTRACT FROM AUTHOR]