Course of the recurrent laryngeal nerve relative to the inferior thyroid artery and the suspensory ligament of Berry.

An awareness of the surgical anatomy and the possible dispositions of the recurrent laryngeal nerve (RLN) is very helpful in avoiding its injury during thyroidectomy. The relationship of the RLN to the inferior thyroid artery (ITA) and the suspensory ligament of Berry were studied in 172 patients undergoing thyroidectomy. One hundred and ninety one nerves were identified, 109 on the right and 82 on the left.

The superior laryngeal nerve in thyroidectomy.

In a clinical prospective study, three cases of superior laryngeal nerve injury were detected after 54 classical high ligations of the superior thyroid artery. On the contrary no injury of the nerve was noted in 227 cases in which the technique of separate ligation of the superior thyroid artery's branches was used. Voice changes secondary to thyroid gland operations, without injury to the recurrent laryngeal nerve, are commonly attributed to laryngeal trauma or tracheitis.