Non-recurrent laryngeal nerve with dual branch pattern and merging: a rare anatomical variant encountered during right hemithyroidectomy.
Badriya Yussuf, Haissan Iftikhar
✦ AI-curated · Sources linked
Case in brief
A woman in her 50s underwent right hemithyroidectomy for a benign compressive multinodular goitre. The recurrent laryngeal nerve was not found in its expected tracheo-oesophageal groove position. Tracing the vagus nerve revealed a right non-recurrent laryngeal nerve that divided into superior and inferior branches, which followed separate courses before rejoining about 10 mm from laryngeal entry. Both branches were identified and preserved. She had normal vocal cord function after extubation and an uncomplicated recovery without voice change at follow-up.
What made this case unusual
The non-recurrent nerve divided into two branches that re-merged before entering the larynx, adding complexity to identification and preservation.
Diagnostic / clinical pearl
When a recurrent laryngeal nerve is absent from its expected course, trace the vagus; follow all identified nerve branches fully, as a non-recurrent nerve may divide and re-merge.