The Non-Recurrent Laryngeal Nerve: a meta-analysis and clinical considerations

PeerJ

article

Brandon Michael Henry¹  Silvia Sanna³  Matthew J. Graves¹  Jens Vikse²  Beatrice Sanna⁵  Iwona M. Tomaszewska⁶  R. Shane Tubbs⁷  Jerzy A. Walocha¹  Krzysztof A. Tomaszewski¹ 

[1] Department of Anatomy, Jagiellonian University Medical College;International Evidence-Based Anatomy Working Group;Department of Surgical Sciences, University of Cagliari;Division of Medicine, Stavanger University Hospital;Faculty of Medicine and Surgery, University of Cagliari;Department of Medical Education, Jagiellonian University Medical College;Seattle Science Foundation

关键词: Arteria lusoria;    Recurrent Laryngeal Nerve;    Meta-analysis;    Non-Recurrent Laryngeal Nerve;    Anatomy;   

DOI  :  10.7717/peerj.3012

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundThe Non-Recurrent Laryngeal Nerve (NRLN) is a rare embryologically-derived variant of the Recurrent Laryngeal Nerve (RLN). The presence of an NRLN significantly increases the risk of iatrogenic injury and operative complications. Our aim was to provide a comprehensive meta-analysis of the overall prevalence of the NRLN, its origin, and its association with an aberrant subclavian artery.MethodsThrough March 2016, a database search was performed of PubMed, CNKI, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science. The references in the included articles were also extensively searched. At least two reviewers judged eligibility and assessed and extracted articles. MetaXL was used for analysis, with all pooled prevalence rates calculated using a random effects model. Heterogeneity among the included studies was assessed using the Chi2 test and the I2 statistic.ResultsFifty-three studies (33,571 right RLNs) reported data on the prevalence of a right NRLN. The pooled prevalence estimate was 0.7% (95% CI [0.6–0.9]). The NRLN was found to originate from the vagus nerve at or above the laryngotracheal junction in 58.3% and below it in 41.7%. A right NRLN was associated with an aberrant subclavian artery in 86.7% of cases.ConclusionThe NRLN is a rare yet very clinically relevant structure for surgeons and is associated with increased risk of iatrogenic injury, most often leading to temporary or permanent vocal cord paralysis. A thorough understanding of the prevalence, origin, and associated pathologies is vital for preventing injuries and complications.

【 授权许可】

CC BY