Surgical Anatomy of the Recurrent Laryngeal Nerves and its Clinical Applications in Chinese Adults

PURPOSE: When removing the thyroid gland, great care must be taken to avoid damaging the recurrent laryngeal nerves (RLNs). The present study aims to present a clear picture of certain anatomical features of the RLNs in relation to the inferior thyroid artery (ITA), the tracheoesophageal groove (TE), Berry's ligament, and the inferior cornu of the thyroid cartilage in Chinese adults. METHODS: We removed a collective 120 RLNs from 60 Chinese adult cadavers (52 men and 8 women), and examined their anatomic course and relationship on both sides. RESULTS: The right and left RLNs were found in the tracheoesophageal groove in 78.3% and 91.3% of cases, respectively. Both RLNs were found posterior to and to the right of the ITA in 80% of cases, and one was found on the left side of the ITA in 91.7%. Most of the RLNs were within 3 mm of Berry's ligament, with a laryngeal entry point about 0.8 cm below and just anterior to the inferior horn of the thyroid cartilage. CONCLUSIONS: The inferior cornu of the thyroid cartilage is a reliable landmark in identifying the RLNs. Racial variations between Caucasians and Chinese may explain some anatomic differences.