A recurrent-like course of the external branch of the superior laryngeal nerve associated with a right-sided aortic arch: a rare anatomical variation.
Sujung Yeom, Hyeongseok Lee, Hwanmin Kim et al.
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Case in brief
A 60-year-old female with papillary thyroid carcinoma underwent total thyroidectomy. Preoperative imaging revealed a right-sided aortic arch with an aberrant left subclavian artery, suggesting potential laryngeal nerve variations. During surgery, both recurrent laryngeal nerves followed a normal course, but an unusual variation of the external branch of the superior laryngeal nerve was found, mimicking a non-recurrent laryngeal nerve. Careful dissection prevented nerve injury.
What made this case unusual
The external branch of the superior laryngeal nerve exhibited a recurrent-like ascending course, which is atypical and can lead to misidentification during surgery.
Diagnostic / clinical pearl
Clinicians should be aware that variations in the anatomy of the superior laryngeal nerve can occur, particularly in the context of vascular anomalies, necessitating careful intraoperative identification.
Why it matters
Understanding these anatomical variations is crucial for preventing nerve injury during thyroid surgeries, as they may not align with expected vascular findings.