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. 2022 Oct;74(Suppl 2):2065-2070.
doi: 10.1007/s12070-020-02018-1. Epub 2020 Aug 2.

Relationship of Recurrent Laryngeal Nerve with Inferior Horn of Thyroid Cartilage, Berry's Ligament and Zuckerkandl's Tubercle

Ozlem Zumre Kastan  1 , Serra Ozturk  2 , Engin Calguner  3 , Bulent Veli Agırdır  4 , Muzaffer Sindel  2
Affiliations

Relationship of Recurrent Laryngeal Nerve with Inferior Horn of Thyroid Cartilage, Berry's Ligament and Zuckerkandl's Tubercle

Ozlem Zumre Kastan et al. Indian J Otolaryngol Head Neck Surg. 2022 Oct.

Abstract

During neck surgery; Zuckerkandl's tubercle, Berry's ligament, the inferior horn of thyroid cartilages have become crucial anatomical landmarks in order to protect the integrity of the recurrent laryngeal nerve. Forty-two male postmortem human cadavers were used. The proximal part of the recurrent laryngeal nerve, before the inferior thyroid artery arises from its source has been observed in 87% inside the tracheoesophageal groove and in 13% running laterally to the trachea. The recurrent laryngeal nerve was encountered passing behind and through the branches of the inferior thyroid artery in 92% and 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. These landmarks and their upper mentioned distances to the laryngeal nerve can be taken into consideration as important surgical guides.

Keywords: Berry’s ligament; Inferior laryngeal nerve; Recurrent laryngeal nerve; Thyroid cartilage; Zuckerkandl’s tubercle.

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Conflict of interest statement

Conflict of interestThe authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
a Recurrent laryngeal nerve (RLN) lying in the tracheoesophageal groove (TOG). b Recurrent laryngeal nerve (RLN) lying laterally of the trachea (T). c Recurrent laryngeal nerve (RLN) passing behind the inferior thyroid artery (ITA), (T: Trachea)
Fig. 2
Fig. 2
a Recurrent laryngeal nerve (RLN) passing between the branches of inferior thyroid artery (ITA). (T: Trachea, TG: Thyroid gland), b Recurrent laryngeal nerve (RLN) in related to inferior corn of the thyroid cartilage (ICTC), c Recurrent laryngeal nerve (RLN) passing inferomedially to the Berry’s ligament (BL), (T:Trachea), d Elevation of Zuckerkandl tubercle ( ZT) laterally and exposed to recurrent laryngeal nerve (RLN), (TG: Thyroid gland)
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