Right Non-Recurrent Laryngeal Nerve Discovered during Total Thyroidectomy: A Case Report

The non-recurrent laryngeal nerve (NRLN) is an infrequent variant of inferior laryngeal nerve that takes an unusual course. Since this is a rare anatomic variation, operations on these patients carry a great risk of laryngeal nerve injury.

A 25-year-old woman with papillary thyroid carcinoma and cervical lymphadenopathy underwent total thyroidectomy and bilateral neck dissection levels II – VI. It was noted intraoperatively that right inferior laryngeal nerve was a NRLN and right common carotid artery originated directly from the aorta and right brachiocephalic artery was absent. The nerve was preserved and patient underwent an uneventful surgery. She was well in her follow-up visits, her voice was good and both of her vocal cords were mobile on indirect laryngoscopy examination.

Although NRLN is a rare anatomic variation, surgeons should always think twice about this finding whenever right recurrent laryngeal nerve cannot be found according to anatomical landmarks intra-operatively.