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Pre-operative prediction of a right non-recurrent laryngeal nerve by computed tomography

Published online by Cambridge University Press:  12 February 2013

B T Varghese ,
K P Desai  and
A Ramachandran
B T Varghese*
Affiliation:
Department of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Trivandrum, India
K P Desai
Affiliation:
Department of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Trivandrum, India
A Ramachandran
Affiliation:
Department of Imageology, Regional Cancer Centre, Trivandrum, India
*
Address for correspondence: Dr B T Varghese, Department of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Medical College Campus, Trivandrum 695 011, India E-mail: bipintv@gmail.com
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Abstract

Objective:

This paper reports a case of a non-recurrent laryngeal nerve which was accurately predicted pre-operatively using computed tomography.

Case report:

A 61-year-old man presented with papillary thyroid carcinoma with lymph node metastasis. Computed tomography scans of the neck and chest revealed an ill-defined, hypoattenuating nodule in the right lobe of the thyroid gland, with few upper paratracheal and prevascular nodes, and clear lung fields. The retro-oesophageal course of the right subclavian artery, which was arising from the distal portion of the arch of aorta, was also incidentally revealed in the computed tomography scan. A barium swallow further confirmed the presence of a retro-oesophageal subclavian artery. Total thyroidectomy was performed, with right neck dissection and central compartment clearance. This was carried out with the presence of a non-recurrent laryngeal nerve in mind, and the nerve was accurately localised and preserved.

Conclusion:

To our knowledge this is the first report in the world literature of accurate pre-operative incidental imaging of the right non-recurrent laryngeal nerve in a case of metastatic thyroid cancer, and the subsequent use of computed tomography to guide surgical navigation.

Keywords

Laryngeal NervesComputed TomographyThyroidectomyInjuriesLaryngeal Nerve InjuriesAnatomy

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 5 , May 2013 , pp. 525 - 527
Copyright
Copyright © JLO (1984) Limited 2013 

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References

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