Non-recurrent laryngeal nerve
Citation, DOI, disclosures and article data
At the time the article was created Travis Fahrenhorst-Jones had no recorded disclosures.
View Travis Fahrenhorst-Jones's current disclosuresAt the time the article was last revised Ciléin Kearns had no financial relationships to ineligible companies to disclose.
View Ciléin Kearns's current disclosuresA non-recurrent laryngeal nerve is an uncommon anatomical variant in which the laryngeal nerve does not descend into and return from the thorax, instead directly entering the larynx from the cervical vagus nerve.
On this page:
Epidemiology
Incidence is rare and varies by study but has been indicated to be as high as 0.57% on the right and 0.07% on left in an observational study of the recurrent laryngeal nerve during neck surgery 1.
Embryology
A right non-recurrent laryngeal nerve usually occurs due to partial regression of the fourth pharyngeal arch, resulting in an aberrant subclavian artery running posterior to the oesophagus 2,3. As a result, the nerve does not loop under a normally placed right subclavian artery before returning superiorly to enter the larynx.
A left non-recurrent laryngeal nerve is very rare, only having been reported a number of times where it accompanied situs inversus 1.
History and etymology
The variant was first reported in the literature in 1823 2,5.
Clinical importance
The presence of an non-recurrent laryngeal nerve is considered a major factor for iatrogenic injury during surgery 4. Patients have a near six-fold increase in risk for intraoperative nerve injury in the presence of an undetected non-recurrent laryngeal nerve 2.
References
- 1. Henry JF, Audiffret J, Denizot A, Plan M. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. (1988) Surgery. 104 (6): 977-84. Pubmed
- 2. Brandon Michael Henry, Silvia Sanna, Matthew J. Graves, Jens Vikse, Beatrice Sanna, Iwona M. Tomaszewska, R. Shane Tubbs, Jerzy A. Walocha, Krzysztof A. Tomaszewski. The Non-Recurrent Laryngeal Nerve: a meta-analysis and clinical considerations. (2017) PeerJ. 5: e3012. doi:10.7717/peerj.3012
- 3. Emmanouil Bakalinis, Ioannis Makris, Theano Demesticha, Georgios Tsakotos, Panagiotis Skandalakis, Dimitrios Filippou. Non-recurrent Laryngeal Nerve and Concurrent Vascular Variants: A Review. (2018) Acta Medica Academica. 47 (2): 186. doi:10.5644/ama2006-124.230
- 4. Dolezel, Radek, Jarosek, Jiri, Hana, Ludek, Ryska, Miroslav. Clinical relevance and surgical anatomy of non-recurrent laryngeal nerve: 7 year experience. (2015) Surgical and Radiologic Anatomy. 37 (4): 321. doi:10.1007/s00276-014-1369-4
- 5. Stedman GW. A Singular Distribution of Some of the Nerves and Arteries in the Neck, and the Top of the Thorax. (1823) Edinburgh medical and surgical journal. 19 (77): 564-565. Pubmed
Incoming Links
Related articles: Anatomy: Head and neck
- skeleton of the head and neck
-
cranial vault
- scalp (mnemonic)
- fontanelle
-
sutures
- calvarial
- facial
- frontozygomatic suture
- frontomaxillary suture
- frontolacrimal suture
- frontonasal suture
- temporozygomatic suture
- zygomaticomaxillary suture
- parietotemporal suture (parietomastoid suture)
- occipitotemporal suture (occipitomastoid suture)
- sphenofrontal suture
- sphenozygomatic suture
- spheno-occipital suture (not a true suture)
- lacrimomaxillary suture
- nasomaxillary suture
- internasal suture
- basal/internal
- skull landmarks
- frontal bone
- temporal bone
- parietal bone
- occipital bone
- skull base (foramina)
-
facial bones
- midline single bones
- paired bilateral bones
- cervical spine
- hyoid bone
- laryngeal cartilages
-
cranial vault
- muscles of the head and neck
- muscles of the tongue (mnemonic)
- muscles of mastication
-
facial muscles
- epicranius muscle
- circumorbital and palpebral muscles
- nasal muscles
-
buccolabial muscles
- elevators, retractors and evertors of the upper lip
- levator labii superioris alaeque nasalis muscle
- levator labii superioris muscle
- zygomaticus major muscle
- zygomaticus minor muscle
- levator anguli oris muscle
- malaris muscle
- risorius muscle
- depressors, retractors and evertors of the lower lip
- depressor labii inferioris muscle
- depressor anguli oris muscle
- mentalis muscle
- compound sphincter
-
orbicularis oris muscle
- incisivus labii superioris muscle
- incisivus labii inferioris muscle
-
orbicularis oris muscle
- muscle of mastication
- modiolus
- elevators, retractors and evertors of the upper lip
- muscles of the middle ear
- orbital muscles
- muscles of the soft palate
- pharyngeal muscles
- suprahyoid muscles
- infrahyoid muscles
- intrinsic muscles of the larynx
- muscles of the neck
- platysma muscle
- longus colli muscle
- longus capitis muscle
- scalenus anterior muscle
- scalenus medius muscle
- scalenus posterior muscle
- scalenus pleuralis muscle
- sternocleidomastoid muscle
-
suboccipital muscles
- rectus capitis posterior major muscle
- rectus capitis posterior minor muscle
- obliquus capitis superior muscle
- obliquus capitis inferior muscle
- accessory muscles of the neck
- deep cervical fascia
-
deep spaces of the neck
- anterior cervical space
- buccal space
- carotid space
- danger space
- deep cervical fascia
- infratemporal fossa
- masticator space
- parapharyngeal space
- stylomandibular tunnel
- parotid space
- pharyngeal (superficial) mucosal space
- perivertebral space
- posterior cervical space
- pterygopalatine fossa
- retropharyngeal space
- suprasternal space (of Burns)
- visceral space
- surgical triangles of the neck
- orbit
- ear
- paranasal sinuses
- upper respiratory tract
- viscera of the neck
- blood supply of the head and neck
-
arterial supply
-
common carotid artery
- carotid body
- carotid bifurcation
- subclavian artery
- variants
-
common carotid artery
- venous drainage
-
arterial supply
- innervation of the head and neck
-
cranial nerves
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
-
trigeminal nerve (CN V) (mnemonic)
- trigeminal ganglion
- ophthalmic division
- maxillary division
- mandibular division
- abducens nerve (CN VI)
- facial nerve (CN VII)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
- vagus nerve (CN X)
- (spinal) accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- parasympathetic ganglia of the head and neck
- cervical sympathetic ganglia
- greater occipital nerve
- third occipital nerve
-
cervical plexus
- muscular branches
- longus capitis
- longus colli
- scalenes
- geniohyoid
- thyrohyoid
-
ansa cervicalis
- omohyoid (superior and inferior bellies separately)
- sternothyroid
- sternohyoid
- phrenic nerve
- contribution to the accessory nerve (CN XI)
- cutaneous branches
- muscular branches
- brachial plexus
- pharyngeal plexus
-
cranial nerves
- lymphatic drainage of the head and neck
- embryological development of the head and neck
Unable to process the form. Check for errors and try again.