What are the electrophysiological parameters of the nonrecurrent laryngeal nerve (NRLN), and how efficient is intraoperative nerve monitoring (IONM) for successful NRLN identification?
IONM is highly effective in NRLN identification. Right vagus nerve latency in the NRLN group was found to be significantly shorter than in the RLN group.
Explore this issue:September 2017
Background: The NRLN is a common anatomic variation of the right recurrent laryngeal nerve (RLN), which has been associated with an increased risk of injury during thyroid and parathyroid surgery. Previous reports suggest that the NRLN may be under-recognized and under-reported, and paresis and paralysis rates may be 10 times higher than the typical RLN. International neural monitoring guidelines call for routine and systematic use of nerve-stimulating equipment in RLN dissection, but there are very limited published data on the value of nerve monitoring for NRLN identification.
Study design: Retrospective database analysis of 15 NRLNs in a total 682 laryngeal nerves from a single surgeon at a tertiary care center between January 2012 and December 2015.