Recurrent laryngeal nerve landmarks revisited

Background. The aim of this work was to evalu- ate, to prove their reliability, the different surgical landmarks previously proposed as a mean to locate the recurrent laryn- geal nerve (RLN). Methods. The necks of 143 (68 male and 76 female) human adult embalmed cadavers were examined. RLN origin and length and its relationship to different landmarks were recorded and results compared with those previously reported. Statistical comparisons were performed using the chi-square test (significance, p � .05). Results. Mostly, RLN is located anterior to the tracheo- esophageal sulcus (41.6%), posterior to the inferior thyroid ar- tery (35.8%), lateral to Berry's ligament (88.1%), below the inferior rim of the inferior constrictor muscle (90.4%), and entering the larynx before its terminal division (54.6%). Conclusions. The position of the RLN in relation to those structures classically considered as landmarks is highly vari- able. The most reliable relationships are those with Berry's liga- ment or the inferior constrictor muscle. V C 2011 Wiley Periodicals, Inc. Head Neck 00: 000-000, 2011