-Karen Bellapianta, MD
Which Side Is Safer? Controversy Continues
In Surgical Exposures in Orthopedics: The Anatomic Approach, Hoppenfeld and de Boer wrote that the recurrent laryngeal nerve is the most important structure at risk during the [anterior cervical] approach.
But which side is the best for performing the surgery is a question that has not been settled. There’s a lot of controversy in the literature about which side of the neck is safer to operate on, Dr. Bellapianta said.
The left recurrent laryngeal nerve is more consistent in its position. It loops around the aorta and is found in the tracheal esophageal groove, ascending along a direct vertical trajectory. The right recurrent laryngeal nerve is inconsistent in its position, entering from a more lateral position after looping around the subclavian artery.