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The External Branch of the Superior Laryngeal Nerve
Its Topographical Anatomy as Related to Surgery of the Neck
Antonius C. Kierner, MD;
Martin Aigner, MD;
Martin Burian, MD
Arch Otolaryngol Head Neck Surg. 1998;124:301-303.
Objective To determine the possible courses of the external branch of the superior laryngeal nerve (EBSLN) and its relationship to the superior thyroid artery (STA) to improve the chances of identifying and saving the nerve during head and neck surgery.
Design Anatomical analysis of the exact topography of the EBSLN.
Subjects Thirty-one perfusion-fixed human cadavers (ie, 62 preparations) of both sexes ranging in age from 50 to 94 years (mean, 78 years) with neither enlarged thyroid glands nor any other signs of abnormality in this region.
Results Four types of relationship between the EBSLN, the upper pole of the thyroid gland, and the STA were found. In 23 preparations (42%), the EBSLN crossed the STA more than 1 cm above the upper pole of the thyroid gland (type 1). In 15 preparations (30%), the EBSLN crossed the STA less than 1 cm above the upper pole of the thyroid gland (type 2). In 7 preparations (14%), the EBSLN crossed the STA under cover of the upper pole of the thyroid gland (type 3). In 7 preparations (14%), the EBSLN descended dorsal to the artery and only crossed the branches of the STA immediately above the upper pole of the thyroid gland (type 4).
Conclusion The description of the variable course of the EBSLN and its categorization may help minimize the risk of iatrogenic lesions of the nerve during surgery.
From the Institute of Anatomy 2, University of Vienna (Drs Kierner and Aigner), and the Department of Otolaryngology, University Hospital of Vienna (Dr Burian), Vienna, Austria.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Superior Laryngeal Nerve Identification and Preservation in Thyroidectomy
Friedman et al.
Arch Otolaryngol Head Neck Surg 2002;128:296-303.
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