Recurrent laryngeal nerve

Last revised by Daniel J Bell on 9 Oct 2023

The recurrent laryngeal nerve (RLN), also known as the inferior laryngeal nerve, is a branch of the vagus nerve (CN X) which has a characteristic loop around the right subclavian artery on the right and the aortic arch on the left before returning up to ascend the tracheoesophageal groove and then the larynx.

Summary

  • location: superior mediastinum and the lower neck regions 

  • origin and course: originates from the vagus nerve (CN X)

    • on the right side, the recurrent laryngeal nerve branches from CN X anteriorly to the subclavian artery and travels inferiorly and posteriorly under the artery before ascending through the neck between the trachea and the esophagus

    • on the left side, the recurrent laryngeal nerve branches from CN X at the aortic arch level and courses posteromedially beneath it before looping through the aortopulmonary window, posterolateral to the ligamentum arteriosum

    • the course from that point is symmetric

  • branches and supply

  • relations: right subclavian artery on the right side and aortic arch on the left

  • variants: non-recurrent laryngeal nerve

History and etymology

The Greek physician, Galen of Pergamon (129-210) was the first to describe the recurrent laryngeal nerve as a branch of a cranial nerve and famously demonstrated its role in vocalization when he accidentally cut the recurrent laryngeal nerve of a squealing pig 4

The word recurrent is derived from the Latin word "recurrere" meaning "to run back" 5. This is in reference to the course of the recurrent laryngeal nerve. 

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