Anatomical Basis of Recurrent Laryngeal Nerve Injury

Clinical Manifestations and Functional Impairments of Nerve Injury

Introduction

The recurrent laryngeal nerve (RLN), a branch of the vagus nerve, plays a critical role in vocal cord function. Injury to this nerve can lead to significant clinical consequences, affecting speech, swallowing, and breathing.

Anatomy of the Recurrent Laryngeal Nerve

The RLN arises from the vagus nerve and loops around different vascular structures: the right RLN loops around the subclavian artery, while the left RLN loops around the aortic arch.

• Innervates intrinsic muscles of the larynx (except the cricothyroid muscle).
• Provides sensory input to the larynx below the vocal cords.

Causes of RLN Injury

Common causes of injury include:

• Thyroidectomy and neck surgeries
• Trauma or compression due to tumors
• Neurological disorders affecting vagus nerve function

Clinical Manifestations

Damage to the RLN can result in:

• Hoarseness or loss of voice
• Dysphagia and aspiration risks
• Stridor due to vocal cord paralysis

Diagnosis and Management

Diagnosis typically involves laryngoscopy to assess vocal cord mobility. Management strategies include voice therapy, surgical interventions, and in severe cases, tracheostomy.

Conclusion

Understanding the anatomical basis of RLN injury is crucial for preventing complications in surgical procedures and optimizing patient outcomes.