Neck ultrasound for prediction of right nonrecurrent laryngeal nerve

Head Neck. 2010 Jul;32(7):844-9. doi: 10.1002/hed.21263.

Abstract

Background: Nonrecurrent laryngeal nerve (NRLN) is 1 of the important causes for nerve damage during neck surgery. The anomaly is almost associated with congenital vascular abnormally. Most neck vascular anomalies can be detected by ultrasound.

Methods: Both 3.5-MHz and 10-MHz probe neck ultrasound scans were performed for 2330 patients undergoing thyroidectomy preoperatively. Absence of innominate artery (INA) was defined as positive with right NRLN.

Results: Of 13 positive patients found by 10-MHz probe, 11 were also identified by 3.5-MHz probe, and proved to be with right NRLN during operation. Two false-positive patients (18%) found by 10-MHz probe were due to short INA and tortuous INA, respectively. The incidence of right NRLN was 0.47% in Chinese people. Both the sensitivity and specificity for predicting right NRLN by 3.5-MHz probe were 100%.

Conclusion: A 3.5-MHz probe neck ultrasound scan can accurately demonstrate right NRLN. Applying this tool for neck surgery to reduce the nerve damage is highly advised.

MeSH terms

  • Brachiocephalic Trunk
  • Cohort Studies
  • Humans
  • Predictive Value of Tests
  • Recurrent Laryngeal Nerve / abnormalities*
  • Recurrent Laryngeal Nerve / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Thyroid Diseases / diagnostic imaging*
  • Thyroid Diseases / pathology
  • Thyroid Diseases / surgery
  • Thyroidectomy
  • Ultrasonography, Doppler, Color*