Abstract
Background. Communicating branches between the cervical sympathetic system and the inferior laryngeal
nerve (ILN) have been described. They usually originate from the middle cervical sympathetic
ganglion (MCSG). These branches (sympathetic-inferior laryngeal anastomotic branch
[SILAB]), usually thin, sometimes have the same diameter as the ILN. In this study
we prospectively evaluated the frequency of this condition and its implications during
surgical neck exploration. Methods. From November 1998 to October 1999, 791 patients underwent surgical neck exploration,
and 1253 ILNs were dissected: 656 on the right side (52.3%) and 597 on the left side
(47.7%). Results. On the right side, a nonrecurrent ILN was found in 3 cases (0.46%), and a large SILAB
was found in 10 cases (1.5%). The SILAB originated from the superior cervical sympathetic
ganglion in 2 cases and directly from the sympathetic trunk above the MCSG in 8 cases.
No anomalous branch was found on the left side. Conclusions. The SILAB may originate not only from the MCSG but also from the superior cervical
sympathetic ganglion or directly from the sympathetic trunk. When the SILAB is as
large as the ILN, it could be mistaken for a nonrecurrent ILN. The awareness of this
anatomic condition during neck dissection may help to avoid injuries of the genuine
ILN running in the usual pathway. (Surgery 2000;128:1082-7.)
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References
- Anatomie médico-chirurgicale du système nerveux végétative: sympatique et parasympathique.: Masson et Cle Editeurs, Paris1933
- Système nerveux sympathique: étude systématique et macroscopique.: Masson et Cle, Editeurs, Paris1952
- Anatomy of the recurrent laryngeal nerve: a redescription.J Laryngol Otol. 1986; 100: 919-927
- Communication between the superior cervical sympathetic ganglion and the inferior laryngeal nerve.J Anat. 1997; 190: 147-148
- Complications of thyroidectomy.Br J Surg. 1994; 81: 1555-1556
- Surgical anatomy and embryology of the thyroid and parathyroid glands and recurrent and external laryngeal nerves.in: Textbook of endocrine surgery. : Saunders, Philadelphia (PA)1997: 8-14
- Complications of thyroid surgery.in: Textbook of endocrine surgery. : Saunders, Philadelphia (PA)1997: 167-173
- The recurrent laryngeal nerve related to thyroid surgery.Am J Surg. 1999; 177: 485-488
- Anastomoses and bifurcations of the recurrent laryngeal nerve: report of 1177 nerves visualized.Am Surg. 1993; 59: 188-191
- An anatomical study of anastomoses between the laryngeal nerves.Laryngoscope. 1999; 109: 983-987
- The nonrecurrent inferior laryngeal nerve: review of 33 cases including two on the left side.Surgery. 1988; 104: 977-984
- Extralaryngeal division of the recurrent laryngeal nerve: report on 400 patients and the 721 nerves measured.Am J Surg. 1986; 152: 407-410
- Nonrecurrent inferior laryngeal nerves and their association with a recurrent branch.Am J Surg. 1983; 146: 501-503
- Nonrecurrent and recurrent inferior laryngeal nerve: a surgical pitfall in cervical exploration.Am J Surg. 1991; 162: 495-496
- The sympathetic innervation of the vocal cord: an experimental study in the guinea pig.J Laryngol Otol. 1987; 101: 1040-1045
- The autonomic innervation of the human vocal cord: neuropeptides.Laryngoscope. 1989; 99: 293-296
Article info
Footnotes
*Reprint requests: Prof Jean François Henry, University Hospital La Timone, 264 Rue Saint Pierre, 13385 Marseilles Cedex 05, France.
**Surgery 2000;128:1082-7.
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Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
