Recurrent laryngeal nerve
Citation, DOI, disclosures and article data
At the time the article was created Bruno Di Muzio had no recorded disclosures.
View Bruno Di Muzio's current disclosuresAt the time the article was last revised Joachim Feger had no financial relationships to ineligible companies to disclose.
View Joachim Feger's current disclosures- Inferior laryngeal nerve
- Recurrent laryngeal nerves
- Inferior laryngeal nerves
- Recurrent laryngeal nerve (RLN)
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
ascent vertically in the tracheoesophageal groove, adjacent to the medial surface of the lobes of the thyroid gland
laryngeal entrance below the inferior border of the inferior pharyngeal constrictor muscle at its lateral attachment to the cricoid cartilage and ascend posterior to the cricothyroid joint
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branches and supply
motor supply to all the intrinsic muscles of the larynx except the cricothyroid muscle, which is supplied by the external laryngeal nerve
sensory and secretomotor supply to the laryngeal mucosal structures below the level of the vocal cords and trachea
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.
References
- 1. Paquette C, Manos D, Psooy B. Unilateral Vocal Cord Paralysis: A Review of CT Findings, Mediastinal Causes, and the Course of the Recurrent Laryngeal Nerves. Radiographics. 2012;32(3):721-40. doi:10.1148/rg.323115129 - Pubmed
- 2. John S. Rubin, Robert T. Sataloff, Gwen S. Korovin. Diagnosis and Treatment of Voice Disorders. (2014) ISBN: 9781597566445 - Google Books
- 3. Susan Standring. Gray's Anatomy. (2020) ISBN: 9780702077050 - Google Books
- 4. Gross C. Galen and the Squealing Pig. Neuroscientist. 1998;4(3):216-21. doi:10.1177/107385849800400317
- 5. Peter Harris, Sue Nagy, Nicholas Vardaxis. Mosby's Dictionary of Medicine, Nursing and Health Professions - Australian & New Zealand Edition - E-Book. (2009) ISBN: 9780729579094 - Google Books
Incoming Links
- External laryngeal nerve
- Ortner syndrome
- Middle layer of the deep cervical fascia
- Differentiated thyroid cancer (staging)
- Vagus nerve
- Aortopulmonary window (radiograph)
- Thyroid cancer (active surveillance)
- Intrinsic muscles of the larynx
- Trachea
- Small cell lung cancer
- Aberrant right subclavian artery
- Middle cervical ganglion
- Thoracic plane
- Medullary thyroid cancer (staging)
- Oesophagectomy
- Inferior pharyngeal constrictor muscle
- Internal laryngeal nerve
- Nucleus ambiguus
- Cervical disc arthroplasty
- Inferior thyroid artery
- Recurrent laryngeal nerve palsy due to hilar lung cancer
- Supraclavicular metastatic lung adenocarcinoma
- Vocal cord paralysis due to aortic arch pseudoaneurysm
- Recurrent laryngeal nerve palsy due to hilar mass
- Fourth branchial cleft fistula
- Vocal cord paralysis due to lung cancer
- Vagal and recurrent nerve schwannoma
- Eagle syndrome with cranial nerve palsies
- Vocal cord paralysis due to esophageal carcinoma
- Vagus and recurrent nerve schwannomas
- Ortner syndrome (cardiovocal syndrome)
- Vocal cord paralysis
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