Résultat de la dissection du nerf laryngé inférieur au cours des thyroïdectomies réglées pour goitres

Abstract

The aim of this work was to describe the intraoperative anatomical aspects of the lower laryngeal nerve during regulated thyroidectomies. This was a prospective, descriptive study of 100 consecutive cases of dissection of the lower laryngeal nerve during regulated thyroidectomies through the year 2019, carried out in the surgical department A of the Niamey national hospital. The study included patients undergoing thyroidectomy with visual detection and dissection of the recurrent nerve. The series included 100 patients including 18 men (18%) and 82 women (82%). The average age was 35 years old. The lower laryngeal nerve was seen and dissected in 98 patients (98%); and in 2 cases (2%), the nerve was not visualized. In total it was seen and dissected 162 lower laryngeal nerves. Intraoperatively, the lower laryngeal nerve was fine on the right and left respectively in 12 cases (14.3%) and 18 cases (23%). Normal nerve appearance was 85.7% (n = 72) on the right, and 76.9% on the left (n = 60). The lower laryngeal nerve was single trunk in 106 cases (65.4%), and with multiple branches in 34.6% (n = 56). The anatomical variations of the lower laryngeal nerve with respect to the thyroid artery were as follows: on the right side type A was the most frequent with 61.9% of the cases (n = 52), and on the left side type B was the most represented 53.8% (n = 42). The subdivision into branches of the nerve occurred in 56 cases (34.5%) with before the arterial crossing in 13.5% (n = 22), at the level of the arterial crossing in 2.4% (n = 4), and after crossing 18.5% (n = 30). The anatomical aspects of the inferior laryngeal nerve are variable. In the absence of a neurostimulation device,knowledge of these anatomical variations, research and identification of the lower laryngeal nerve helps prevent damage to this last.

Keywords: inferior laryngeal nerve, thyroidectomy, Niamey.